What is a Keloid?
Keloids are elevated scar tissue outgrowths that develop at the site of a skin injury. They occur where the skin has been wounded by trauma, surgery, blisters, immunizations, acne, or body piercing. Keloids can occur in areas of the skin when there is no obvious damage. Keloids are distinct from mature scars in terms of substance and size. Certain individuals are predisposed to keloid formation and may develop them in multiple locations.
African-Americans are more likely to develop keloids. They are most frequently found on the shoulders, upper back, and chest, but can appear anywhere. When a keloid develops as a result of a skin incision or injury, the keloid scar tissue continues to grow for a period of time after the original wound has healed, becoming larger and more apparent until it reaches its final size. They often arise between the ages of 10 and 30 and are equally prevalent in both sexes, though they may be more prevalent in young women with pierced ears. In patients who have undergone open-heart surgery, keloids may grow above the breastbone.
Symptoms
Keloids are most frequently found in locations of past trauma but may extend beyond the area of injury. They are smooth, spherical, and shiny skin elevations that might be pink, purple, or brown in color. They might be doughy or stiff and rubbery to the touch, and frequently have an itchy, tender, or unpleasant sensation. They may be unpleasant. A big keloid over a joint may impair joint function.
Diagnosis
The look of the keloid and history of tissue injuries, such as surgery, acne, or body piercing, help the doctor diagnose it. In exceptional circumstances, the doctor may remove a small section of skin to examine under a microscope. This is referred to as a biopsy.
Duration
Keloids can grow slowly for weeks, months, or even years. Their growth stops, but they don't go away on their own. Once a keloid forms, it is permanent unless it is removed or effectively treated. Keloids that have been removed or treated frequently regrow.
Prevention
Individuals at risk of developing keloids should avoid cosmetic surgery. When such patients require surgery, doctors can take extra steps to prevent the growth of keloids at the incision site. Several techniques may be used to minimize keloid formation, including covering the healing wound with hypoallergenic paper tape for several weeks following surgery, covering the wound with small silicone gel sheets following surgery, and initiating the healing period with corticosteroid injections or radiation treatments at the surgical wound site.
Treatment
For keloids, there is no one-size-fits-all treatment, and most procedures don't produce the desired results for patients. Combinations of two or more treatments are possible. If you choose to treat a keloid scar, it is recommended to begin treatment as soon as the keloid arises. Among the available treatments are the following:
Conventional surgery removal – This unreliable procedure requires extreme caution, and keloids that recur after removal may be larger than the original. When keloids are surgically excised, more than 45% of persons experience recurrence. When keloids are surgically removed in conjunction with other treatments, they are less likely to recur.
Dressings – Studies have revealed that moist wound dressings consisting of silicone gel sheets can occasionally diminish the size of keloids over time. This procedure is completely safe and painless.
Corticosteroid injections – Triamcinolone acetonide or another corticosteroid medication is commonly injected into keloids at four- to six-week intervals. This treatment frequently results in a reduction in keloid size and inflammation, however, injections are painful.
Compression – This procedure entails applying continuous pressure 24 hours a day for a period of six to twelve months using a bandage or tape. Compression might result in the shrinkage of a keloid. After one year of compression, a clip called a "Zimmer splint" typically reduces the size of keloids that grow at the site of an ear-piercing by at least 50%. Zimmer splints in the shape of earrings are also available.
Cryosurgery – This liquid nitrogen-freezing procedure is repeated every 20 to 30 days. It may have the unintended consequence of lightening the skin's hue, limiting the treatment's usefulness.
It may have the unintended consequence of lightening the skin's hue, limiting the treatment's usefulness.
Radiation therapy – This is a contentious procedure because it raises the risk of cancer. Radiation therapies may help prevent the production of scars if they are applied shortly after surgery, during the healing process of a surgical wound.
Laser therapy – This is a non-invasive procedure that can be used in place of conventional surgery for keloid excision. There is no convincing evidence that keloids are less likely to recur following laser treatment than they are following conventional surgery. There is no convincing evidence that keloids are less likely to recur following laser treatment than they are following conventional surgery.
Fluorouracil injections — When other measures have failed, injections of the chemotherapy drug fluorouracil and triamcinolone into the keloids have been used.
When Should You Talk To A doctor?
Keloids are predominantly an aesthetic issue. If a scar grows larger, itchy, or unpleasant, impairs joint movement, or has an unfavorable cosmetic appearance, consult your doctor about treatment alternatives.
Prognosis
Keloids are noncancerous skin lesions (malignant). Once a keloid has ceased to grow, it often remains stable unless the area is re-injured.
