Recognizing Scars

What are Keloids and Hypertrophic Scars?

Keloid Scars

A keloid scar is a lump that is red in color that develops where an injury has occurred. Once there has been an injury to the skin, the cells of the skin and fibroblasts (cells of the tissue) start growing in an effort to restore the harm that has been done. A scar consists of ‘connective tissue’, gristle-like material dumped into the skin by the fibroblasts to help the injury close. With a keloid scar, the fibroblasts keep increasing even following the wound filling in. Therefore, a keloid scar protrudes above the skins surface allowing larger heap of scar tissue to appear. 

Keloids can occur anywhere on the body; however, the upper region of the chest and back and the shoulders are particularly susceptible to keloids forming. Symptoms include skin discoloration, itching, red color, abnormal feelings and pain.

Estimates have been that around ten percent of the population has keloids occur. The majority of people never experience keloids, but some do experience them after a minor injury, insect bite or even a pimple.  Those who have a dark pigmentation tend to be more susceptible to getting keloid scars and the effects are no different for men or women.

Hypertrophic scars

Hypertrophic scars looks much like a keloid, however, a hypertrophic scar is more common. These are not as large as keloids, can even fade over time and happen within every racial group. Keloids are thought of as a benign tumor, but mostly they are a simply a scar that looks unattractive and will never develop into cancer. Surgery done on a keloid scar generally causes more scar tissue to grow so in many cases those suffering from them will be informed that surgery will not really do them any good.

Keloids can sometimes be prevented if you use a pressure dressing, silicone gel pad or paper tape to cover the wound for twenty-three hours every day.  This therapy should be done following the wound healing which is generally not more than a month.   However, once the scar has begun to form there is not exact treatment.  Treatment options can include cryosurgery or freezing, excisions, lasers, x-rays, and injections of steroids.

The best early treatment option is to have an injection of long-acting cortisone (steroid) in the keloid one-time per month. Following numerous cortisone injections, the keloid will frequently become less noticeable and become flatter in 3 to 6 months.  Hypertrophic scars frequently respond fully, but keloids are known for being difficult to take care of, with recurrences happening often. Those with keloids in their family’s history run a much greater risk of them reoccurring following treatment.

Cryosurgery is a great way to treat keloids which are smaller and happen on skin that has a light pigment and is frequently mixed with cortisone injections each month. Earlobe keloids are generally surgically removed and afterward numerous injections of steroids. Also, a medication named alpha-interferon will be injected into the scar right after the keloid is removed, having extremely positive results.  Treatment using lasers can help with skin color or texture but will not always make the skin flat again.

In extreme instances, the keloid can be removed during surgery and x-ray treatment can be given to the location directly following, typically the same day. This method will work in approximately eighty-five percent of extreme cases.   An electron beam radiation might be given and this method does not go deeply into the body so it does not affect any of the internal organs.  Ortho-voltage radiation is more penetrating and a little more successful. So far, no reports have been made that this treatment has caused cancer in all of the years it has been used, however, it is extremely expensive.  Silicone pads and various creams can be purchased over-the-counter to use on keloids. These will help hypertrophic scars but cannot cure a real keloid, but they can decrease any pain, itching or swelling associated with a keloid and will generally take around three months, sometimes more to actually work.

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