Scar Treatment

Keloid Scar. What it is & what are the best treatments

keloid scar treatment

Although keloids don’t have any pathology, except for the occasional intense itching, they have a strong psychological impact as they cannot get covered by makeup or otherwise. Unfortunately, plastic surgery is not the sure cure for keloids as they tend to return. But that doesn’t mean you can not deal with them effectively.

What are keloids?

Keloids are hypertrophic scars that in contrast cause itching and extend beyond the boundaries of the original wound, are red or cherry with small vessels on their surface and are therefore more visible.

However, this is not the case from the beginning. After the injury and during the first month they appear as a pink scar located above the level of the wound. Then for many months it begins to redden (or darken) and turns into a smooth and shiny plaque that has increased volume compared to the original wound.

In general, keloids develop over a long period of time (several months) and even an old keloid can be activated after months or even years. If an old keloid starts itching then it usually means it is still growing.

If a scar is itchy, painful or makes you feel a burning sensation then it is very likely that it develops into keloid.

Where do we find them?

They can grow on top of any scar on the body but usually develop on the:

  • Back
  • Chest
  • Shoulders
  • Jaw
  • Knee
  • Ear lobes

What causes keloids?

Keloids are formed when the body produces too much collagen after an initial wound has healed.

Although we all usually have a keloid from a vaccine, science has not yet deciphered the complete mechanism of a keloid development and only a few kinds have been linked to a gene. This is also the reason why even the surgical treatment of keloids not only doesn’t guarantee complete recovery but many times keloids are regenerated and in fact with several chances to have larger dimensions than the original scar.

Heredity certainly plays a very big role since if a person has developed keloids, it is likely to develop again in the next trauma. In general, scars turn into keloids after:

  • Injury
  • Surgery ( like caesarean )
  • Burn
  • Vaccine
  • Tattoo
  • Earrings - Piercing
  • Acne
  • Insect bites

What do the statistics reveal?

In a recent research in 2019, studying a sample of 1659 people with keloids, it is clear that women are more prone than men, especially during adolescence. The reason seems to be pathological but unfortunately it has not been determined yet.

Also striking is the fact that keloids have higher growth rates in people with dark skin. A study published in the summer of 2020 by Sarah McGinty and Waqas J. Siddiqui shows that higher levels of melanin in the skin of people of African, Asian and Latin American descent increase keloid growth rates compared to Caucasians by 4.5% to 16%. This percentage becomes even higher during pregnancy and adolescence.

In general, young people from puberty onwards are more prone, the frequency decreases significantly in middle-aged people and is minimal in the elderly. Finally, keloids are more common in women during pregnancy after a cesarean section.

Ways to treat keloids

Keloids are a challenge in recovery for dermatologists and plastic surgeons since an operation is not going to completely solve the problem, while there is always a good chance to return. In general, there are several keloid treatment options, but none of them promises guaranteed results or complete erasure of the scar.

The goal is to smooth the keloid as much as we can, but the secret lies in the prevention and proper care of a keloid before it even develops.

1. Pressing method with silicone sheets for keloids

Since 1970, it has been observed that by exerting constant pressure on the keloid, neoangiogenesis is suppressed and the scar shrinks. So, since the early 80s, silicone sheets for keloids are the best and most economical way to prevent a hypertrophic scar from turning into keloid but also the treatment method with the best results.

Recent research has clearly shown phenomenal improvement in color, thickness and elasticity for both hypertrophic scars and keloids after silicone dressing treatment.

treatment of keloids with silicone sheets, before and after

For best results, doctors and researchers recommend:

  • Starting treatment immediately, ie when the scar is younger than three months, but is equally effective for old scars and keloids
  • At least four hours application of the silicone sheet daily and for at least three months

2. Cryotherapy with liquid nitrogen

Cryotherapy works by causing massive cooling by spraying on relatively small keloids and is quite an effective method but requires monthly repetitions and often has serious side effects.

3. Steroid injections

A fairly popular treatment method where it is based on the injection of cortisone on the keloid that usually improves its texture. Although the steroids used aren’t absorbed by the body there are often some side effects.

4. Laser Therapy

During the laser application, a red ray is emitted which is absorbed by the red color (oxyhemoglobin of the blood vessels) of the keloid, resulting in its shrinkage. That is why it is very important that the laser treatment is applied to the most recent keloids as possible, so that they are redder to have better results.

And in this method of keloid repair, the percentage of improvement in the appearance of the scar cannot be predicted, while many sessions are needed every three or four weeks. Even if you choose laser keloid treatment, doctors always recommend combining it with silicone sheets for maximum results.

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