Keloid scars
Scars are formed as a consequent of tissue injury, repair and remodelling. When repair and remodelling goes wrong, abnormal and unsightly scars are formed. Keloids are due to the overzealous production of collagen in response to tissue injury. These collagen are arranged haphazardly into whorls.
How does keloid looks like?
Keloids are reddish to purplish elevated scars that feels firm and infiltrates to the surroundly, beyond the site of the initial injury. It is like a growth that enlarges to the surrounding. Often, it may have tiny extensions to the peripheries. Some keloids form a spherical nodule, i.e. over the ears.
It is often confused with hypertrophic scar, which is also an elevated reddish scar. However, it does not penetrate or infiltrate the surrounding and remains confined to the site of injury.
Does keloid go away?
Keloids very rarely resolve on its own. On the other hand, hypertrophic scars may regress with time. Most of the time, keloids can continue to grow or remain static in size.
Why do I get keloid?
There are a few reasons why some people are more prone to keloids. It tends to run in the family. This means that if any of your blood-borne relatives has keloids, you have a higher risk of getting it.
Apart from that, there are areas on the body that are more prone for keloids, i.e. chest, shoulder, chin and ears.
It’s just a scar, why do I bother?
It is does not bother you, you can just leave it alone. However, some keloids may itch or even causes pain. Occasionally some keloids may be infected and may even ulcerate. When it causes problems, it is best to treat it.
What are the treatment options?
Depending on the severity and site of the keloid, treatment may differs with each patient.
In general, the treatment can be anything from creams, to injections, to surgeries or even laser and light therapy.
Occlusive therapy with silicone or steroids alone or with compressive therapy may work. Compression can be used alone in mild cases using elastic adhesive bandage or compressive wraps.
Steroids can be injected in keloids to reduce the size of the keloid. Other alternatives include application of liquid nitrogen either by dipping or spraying.
Surgery is often not the choice of therapy except in ear keloids as surgery causes more tissue injury and risk further keloid formation. In some selected cases, surgery to excise keloids coupled with injection of steroid may be useful.
Many light and laser therapy also offers benefit. These include intensed pulse light, pulsed dye laser, ablative CO2 and etc.
However, it most cases, treatment may not completely heal the keloid. The mainstay of the treatment remains to reduce or treat associated symptoms (itch and pain) and to reduce the size and unsightliness of the keloid.
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