What are Keloids?
Keloids can
be described as "scars that don't know when to stop." Keloids are
also referred to as a keloid scar. It is
a tough heaped-up scar that rises quite abruptly above the rest of the skin. It
usually has a smooth top and a pink or purple color. Keloids are irregular in
shape and tend to enlarge progressively. Unlike scars, keloids do not regress
over time. A keloid scar is benign and not contagious, but sometimes
accompanied by severe itchiness, pain, and changes in texture.
In severe
cases, it can affect movement of skin. Keloid scars are seen 15 times more
frequently in people of African descent than in people of European descent. Keloids
should not be confused with hypertrophic scars, which are raised scars that do
not grow beyond the boundaries of the original wound
CAUSES
Doctors do
not understand exactly why keloids form. Alterations in the cellular signals
that control proliferation and inflammation may be related to the process of
keloid formation, but these changes have not yet been characterized
sufficiently to explain this defect in wound healing. So basically, It is a
result of an overgrowth of granulation tissue (collagen type 3) at the site of
a healed skin injury which is then slowly replaced by collagen type 1.
Keloids can
develop following the minor injuries that occur with body piercing. Since this
form of physical adornment has become so popular, the presence of keloidal
scarring is much more prevalent. Since is not yet understood why some people
are more prone to developing keloids, it is impossible to predict whether one's
piercing will lead to keloid formation. Although there are some families that
seem prone to forming keloids, for the most part, it's impossible to tell who
will develop a keloid. It is wise for someone who has formed one keloid to
avoid any elective surgery or cosmetic piercing of any body part.
SYMPTOMS
Keloids
expand in claw-like growths over normal skin. They have the capability to hurt
with a needle-like pain or to itch, although the degree of sensation varies
from person to person.
If the
keloid becomes infected, it may ulcerate. Removing the scar is one treatment
option; however, it may result in more severe consequences: the probability
that the resulting surgery scar will also become a keloid is high, usually
greater than 50%.
CAN KELOIDS BE REMOVED?
The decision
about when to treat a keloid depends on the individual and the symptoms
associated with its development and its anatomical location. A chronically
itchy and irritated keloid can be quite distracting. Keloids in cosmetically
sensitive areas that cause disfigurement or embarrassment are obvious
candidates for treatment. The larger the keloids the more difficult it is to
treat.
TREATMENT
Keloid
treatment methods includes:
Corticosteroid injections
(intralesional steroids): These are safe but moderately painful. Injections are usually given once
every four to eight weeks into the keloids and usually help flatten keloids; however,
steroid injections can also make the flattened keloid redder by stimulating the
formation of more superficial blood vessels.
Surgery: This is risky because cutting a
keloid can trigger the formation of a similar or larger keloid. Some surgeons
achieve success by injecting steroids or applying compression (using a
specialized pressure device where appropriate) to the wound site for months
after cutting away the keloid.
Laser: The pulsed-dye laser can be
effective at flattening keloids and making them look less red. Treatment is
safe and not very painful, but several treatment sessions may be needed. This
method is costly, since it requires several sessions.
Silicone gel or sheeting: This involves wearing a sheet of
silicone gel on the affected area continuously for months, which is hard to
sustain. Results are variable.
Pressure: Special earrings are available,
which when used appropriately, can cause keloids on the earlobe to shrink
significantly.
Cryotherapy: Freezing keloids with liquid
nitrogen may flatten them but often darkens or lightens the site of treatment.
Fluorouracil and bleomycin: Injections of these chemotherapeutic
(anti-cancer) agents, alone or together with steroids, have been used for
treatment of keloids.
Radiation: Some doctors have reported safe and
effective use of radiation to treat keloids
IS KELOID PREVENTABLE?
The answer
is NO.
The best way
to deal with a keloid is not to get one. A person who has had a keloid should
not undergo elective or cosmetic skin surgeries or procedures such as piercing
