KELOIDS AND TREATMENTS

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