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Keloids Keloids
are raised, reddish nodules that develop at the site of an injury. After a
wound has occurred to the skin both skin cells and connective tissue cells
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- Keloids And
Hypertrophic Scars
-
 Keloids
are raised, reddish nodules that develop at the site of an
injury. After a wound has occurred to the skin both skin
cells and connective tissue cells (fibroblasts) begin
multiplying to repair the damage. A scar is made up of
'connective tissue', gristle-like fibers deposited in the
skin by the fibroblasts to hold the wound closed. With
keloids, the fibroblasts continue to multiply even after
the wound is filled in. Thus keloids project above the
surface of the skin and form large mounds of scar tissue.
Keloids may form on any part of the body, although the
upper chest, shoulders and upper back are especially prone
to keloid formation. Symptoms include pigmentation of the
skin, itchiness, redness, unusual sensations and pain.
It is estimated that keloids occur in about 10% of people.
While most people never form keloids, others develop them
after minor injuries, even insect bites or pimples. Darkly
pigmented people seem to be more prone to forming keloids.
Men and women are equally affected.
 A
hypertrophic scar looks similar to a keloid. Hypertrophic
scars are more common. They don't get a big as keloids,
and may fade with time. They occur in all racial groups.
Keloids are considered a benign tumor, but they are mainly
a cosmetic nuisance and never become malignant. Operating
on a keloid usually stimulates more scar tissue to form,
so people with keloids may have been told that there is
nothing that can be done to get rid of them.
Keloids may be often be prevented by using a pressure
dressing, silicone gel pad or paper tape over the injury
site. These are left on for 23 of 24 hours each day. This
treatment is after healing of the wound or injury, usually
within a month. Once they have formed, there is no
completely satisfactory treatment for keloids. Treatments
include cryosurgery (freezing), excision, laser, x-rays,
and steroid injections.
The best initial treatment is to inject long-acting
cortisone (steroid) into the keloid once a month. After
several injections with cortisone, the keloid usually
becomes less noticeable and flattens in three to six
month's time. Hypertrophic scars often respond completely,
but keloids and are notoriously difficult to treat, with
recurrences commonly seen. People who have a family
history of keloids have a higher rate of recurrence after
treatment.
Cryosurgery is an excellent treatment for keloids that are
small and occur on lightly pigmented skin. It is often
combined with monthly cortisone injections. Earlobe
keloids are often surgically excised and followed with
several steroid injections. In addition, a drug called
alpha-interferon has been injected into the scar
immediately after keloid removal with very promising
results. Laser treatment is very good at improving skin
texture and color, but doesn't always flatten out the
keloid.
For
severe cases, the keloid can surgically excised and given
x-ray treatments to the site immediately afterwards,
usually the on the same day. This works in about 85% of
the most severe cases. Electron beam radiation can be
used, which will not go deep enough to affect internal
organs. Orthovoltage radiation is more penetrating and
slightly more effective. There have not been any reports
of this causing any form of cancer in many years of use,
but it is very expensive. Silicone pads and creams are
sold over the counter for use on keloids. These do benefit
hypertrophic scars but will not cure a true keloid.
However, they can reduce pain, swelling and itching from a
keloid. They usually take 3 months or more to work.
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Face
