Keloid scars

Keloid scars are raised, shiny, and smooth growths that form over healed skin injuries. Unlike typical scars, keloids extend beyond the original wound site and can be larger than the initial injury itself. They are caused by an overgrowth of collagen during the healing process, often resulting from trauma, surgery, acne, or piercings. Keloids are more common in individuals with darker skin tones and can be itchy, tender, or painful. Treatment options include corticosteroid injections, cryotherapy, laser therapy, or surgical removal, although recurrence rates can be high.

If you suspect you or someone else is experiencing Keloid Scars, it is crucial to seek immediate medical attention by calling emergency services or consult with a Dermatologist.

Causes

Genetics: A genetic predisposition is a significant factor in keloid formation. Individuals with a family history of keloids are more likely to develop them.
Injury or Trauma: Keloids often develop at the site of skin injury or trauma, such as surgical scars, burns, cuts, piercings, or severe acne.
Inflammation: Conditions that cause chronic inflammation, like acne or skin infections, can increase the likelihood of keloid formation.
Skin Type: People with darker skin tones, particularly those of African, Hispanic, or Asian descent, are more prone to keloid scars compared to individuals with lighter skin.
Hormonal Changes: Fluctuations in hormone levels, such as during puberty, pregnancy, or menopause, can contribute to keloid formation.
Foreign Body Reactions: Presence of foreign materials like implants or sutures can sometimes trigger keloid formation.
Age: Keloids are more common in younger individuals, with peak incidence occurring between 10 to 30 years of age.

Risk Factors

• Genetics: Family history plays a significant role, as keloids tend to run in families.
• Ethnicity: Individuals with darker skin tones, such as African, Hispanic, and Asian descent, are more prone to keloid formation.
• Age: Keloids are more common in young adults, typically appearing between the ages of 10 and 30.
• Wound Type: Any injury to the skin, including surgical scars, burns, acne scars, or piercings, can potentially develop into keloids.
• Hormones: Changes in hormone levels, such as during puberty, pregnancy, or with hormonal therapies, can influence keloid formation.
• Tension on Skin: High tension areas on the skin, such as the chest, shoulders, and earlobes, are more likely to develop keloids.
• Inflammatory Conditions: Skin conditions that cause inflammation, like acne or folliculitis, may increase the risk.
• Trauma: Excessive trauma or repeated irritation to a healing wound can trigger keloid formation.
• Infection: Wounds that become infected have an increased risk of developing keloids.

Symptoms

Raised Appearance: Keloids are raised above the skin's surface and often have a smooth, shiny appearance.
Thick, Rubbery Texture: They typically feel firm and rubbery to the touch, differing in texture from surrounding skin.
Discoloration: Keloids may appear darker or lighter than the surrounding skin tone, depending on individual skin pigmentation.
Itching or Tenderness: Some keloid scars can be itchy or tender, causing discomfort or irritation.
Growth Over Time: Keloids may grow larger gradually, extending beyond the original wound area.
Potential for Pain: In some cases, keloid scars can be sensitive to touch or pressure, causing pain or discomfort.
Restriction of Movement: Large keloids near joints or on mobile parts of the body may restrict movement due to their size and stiffness.

Diagnosis

Visual Examination: Doctors primarily diagnose keloid scars based on their appearance. Keloids are raised, shiny, and often have a smooth top compared to the surrounding skin.
Patient History: Understanding the patient's medical history is crucial. Keloids may develop at sites of previous skin trauma, such as surgical scars, piercings, burns, or acne.
Symptoms: Patients may report symptoms such as itching, pain, or tenderness associated with the keloid.
Physical Examination: Physicians examine the size, shape, and texture of the keloid scar. They may also assess its growth pattern over time.
Differential Diagnosis: Distinguishing keloids from other types of scars or skin conditions (such as hypertrophic scars, dermatofibromas, or skin cancers) is essential through careful examination and sometimes biopsy.
Biopsy: In some cases, a biopsy may be performed to confirm the diagnosis. This involves taking a small sample of tissue from the keloid for microscopic examination to rule out other conditions and confirm the presence of keloidal tissue.
Medical Imaging: Rarely, imaging studies such as ultrasound or MRI may be used to evaluate the extent of keloid involvement, especially in larger or complex cases.
Consultation: Referral to a dermatologist or plastic surgeon may be recommended for further evaluation and management, particularly for severe or recurrent keloids.

Treatments

Steroid Injections: Injecting corticosteroids directly into the keloid can help flatten and soften the scar tissue.
Surgical Removal: Excision of the keloid followed by careful closure of the wound. This may be combined with other treatments to prevent recurrence.
Cryotherapy: Freezing the keloid with liquid nitrogen to reduce its size and flatten it.
Laser Therapy: Using various types of lasers to reduce redness and flatten the scar tissue.
Pressure Therapy: Applying pressure dressings or silicone gel pads over the keloid to flatten it over time.
Radiotherapy: Low-dose radiation therapy post-surgery to reduce the risk of keloid recurrence.
Topical Treatments: Application of silicone-based gels or sheets to flatten and soften the scar.
Natural Remedies: Some individuals find relief with natural remedies like onion extract, aloe vera, or vitamin E oil, although scientific evidence supporting their effectiveness is limited.

Preventive Measures

Avoidance of Trauma: Minimize unnecessary trauma to the skin, such as piercings, tattoos, or elective surgeries, especially if prone to keloid formation.
Pressure Therapy: Apply pressure dressings or silicone gel sheets to new wounds to reduce the likelihood of keloid formation.
Early Wound Care: Promptly treat wounds and injuries to promote proper healing and reduce the risk of abnormal scar formation.
Steroid Injections: Consider steroid injections into the healing wound site, which can help prevent excessive collagen formation characteristic of keloids.
Avoidance of Irritation: Prevent irritation to the skin by avoiding tight clothing or materials that may rub against healing wounds.
Sun Protection: Protect healing scars from sun exposure with sunscreen or clothing to prevent pigmentation changes that can exacerbate keloid formation.
Genetic Counseling: If a family history of keloids exists, consider genetic counseling to understand the risks and preventive strategies better.
Medical Consultation: Consult with a dermatologist or plastic surgeon for personalized advice on keloid prevention, especially if prone to keloid scars or undergoing procedures known to trigger keloid formation.

Do's & Don’t's

If you suspect you or someone else is experiencing Keloid Scars, it is crucial to seek immediate medical attention by calling emergency services or consult with a Dermatologist.