Definition

Keloid scars simply means your skin has suffered a wound .

Most frequently, an injury or surgical procedure results in this.

Your body has tissues referred to as fibrous tissue.

These tissues, also referred to as scar tissues, will form scars directly over a wound.

There can occasionally be an overabundance of scarring tissue, which leads to a hard growth and extensive scarring.

A keloid is the name for this growth, which can grow much larger than the original wound.

Although it is a form of tumor, a keloid is not malignant.

They are regarded as chronic, and they typically appear soon after surgery.

Other factors that can result in these tumors include burns, ear piercing, chickenpox, and and injuries to your skin .

Unfortunately, genetic predisposition to the development of keloid tissues can exist in Asians, Latinos, and African Americans.

Pathophysiology of keloid scars

There is a balance between tissue destruction and the production of new tissue during normal wound healing.

This is accomplished through the process of apoptosis and extracellular matrix remodeling (ECM).

A prolonged inflammatory phase is present during keloid development (due to immune cell infiltration into the scar tissue).

This causes the tissue to protrude past the original wound boundary due to excessive ECM synthesis and excess fibroblast activity.

 Risk factors

Keloid scars occur in about 10% of the population .Why some people have keloid scars and others don't is unknown.

But there are a number of things that make them more likely to happen.

African, Asian, Hispanic, and Latino ancestry are risk factors for keloid scarring.

For those in these groups with darker skin tones, the risk is 15–20% higher, and between the ages of 10 and 30.

    Family history of keloid scars About 1 in 3 people with keloids have a parent, sibling or child who also has them.

Additionally, keloid scars and sex hormones may be related.

According to research, pregnancy and puberty are times when keloid scarring is most common.

After menopause, keloid scars on women typically get smaller.

Keloid scar causes

Your skin's cells attempt to heal an injury by creating a scar.

Long after the wound has healed, scar tissue continues to grow in some people.

The elevated spot on your skin known as a keloid is brought on by this additional scar tissue.

Physicians are still unsure of why certain people's skin scars in this manner.

A keloid can develop as a result of numerous different skin injuries.

These consist of:

Cuts

Puncture marks

Incisional scars

Extreme acne

The chickenpox

Mosquito bites

Injection locations

Piercings

Tattoos

When they scar, certain people are more prone to developing a keloid.

If you are Black, Latino, or Asian, you have a higher chance of developing a keloid.

You are a person under 30 years old.

You are expecting.

When you were a teen, you went through puberty.

You come from a family where keloids have a history.

15% to 20% more people with darker skin will develop keloids.

Keloid scars symptoms

Keloid scars typically take time to form and expand.

A keloid scar might take many months or even longer than a year to develop.

Weeks, months, or even years may pass before the proliferating scar stops growing and spreading.

A keloid scar, however, has the potential to develop and expand very quickly.

They come in a variety of sizes, from tiny spots to 12 inches or larger growths.

The ears, face, neck, shoulders, upper back, and chest are where they typically show up.

The larger scars are typically found on the upper trunk.

Typical signs of keloid scars include:

Tenderness, itchiness, or pain.

Large scars might also restrict motion in the body portion that has been injured.

either pink, red, or purple.

Typically, the scar is darker than the person's natural skin color.

With time and sun exposure, it can continue to get darker.

A raised skin surface that is different in texture from the skin around it.

Usually, the raised section is immovable because it is fastened in place.

Larger keloids may make it difficult to move.

Texture can be soft, rubbery, or firm.

Consult your doctor if a scar is forming unnaturally.

A keloid scar can have a negative impact on your quality of life and self-esteem even when it doesn't provide a health concern.

They may react to treatment, but they won't go away on their own.

To handle the issue successfully, a dermatologist recommendation could be required.

Complications

Although uncommon, complications can happen.

When keloid is present in specific locations, such as bends and joints, or while receiving therapies like steroidal injections or external irritating applications, or if you have diabetes, neurological diseases, or other conditions, medical complications can develop.

When it flares up, it may result with increased pain and itching, contractures, and movement restrictions in the affected areas.

Issues that could arise

Alterations to the appearance's look

The most typical complication for which patients seek medical attention is this one.

Keloid discomfort, soreness, or tenderness.

Irritation of the Keloids brought on by clothing rubbing or other types of friction.

Limited mobility: Because of contractures in the skin and its tissues, severe keloids after burns or injuries can restrict the mobility of bodily parts.

Psychiatric anguish

When keloids are exceedingly large or disfiguring, they can have an emotional impact on the person.

 

Diagnosis and test

Usually, a dermatologist can identify a keloid only by looking at it.

A dermatologist may take a skin sample if a keloid resembles a concerning skin development.

To do this, a little part must be removed so that it can be examined under a microscope.

During a visit to the office, a dermatologist can swiftly and easily remove a tiny piece.

Treatment and medications

Keloids cannot be treated in a single way, and the majority of methods only partially satisfy patients.

Combining two or more therapies is possible.

The best outcomes will be achieved if you begin treatment as soon as the keloid first arises if you choose to pursue treatment for a keloid scar.

Among the available remedies are:

Removal with conventional surgery-

This risky procedure necessitates extreme caution, and keloids that reappear after removal could be bigger than the original.

When keloids are surgically excised, more than 45% of patients experience a recurrence.

If alternative treatments are used in addition to surgical removal, keloids are less likely to recur.

Dressings: Studies have indicated that silicone gel sheets used as moist wound dressings can occasionally cause keloids to gradually shrink in size.

This procedure is painless and safe.

Triamcinolone acetonide or another corticosteroid medication is commonly administered via injection into keloids at intervals of four to six weeks.

Injections hurt, but this treatment frequently reduces keloid size and inflammation.

Compression is the process of continuously applying pressure for six to twelve months with the help of a bandage or tape.

The size of a keloid may decrease as a result of compression.

After one year of compression, a "Zimmer splint" clip for keloids that develop at the site of an ear piercing often reduces keloid size by at least 50%.

There are Zimmer splints that look like earrings.

Cryosurgery: This liquid nitrogen freezing procedure is repeated every 20 to 30 days.

The potential side effect of skin whitening restricts the efficacy of this treatment.

Radiation therapy is debatable since it raises the risk of developing cancer.

If radiation therapy is used soon after surgery, when the surgical wound is healing, it may prevent the production of scars.

Laser therapy- This is an alternative to conventional surgery for keloid removal. There is no good evidence that keloids are less likely to return after laser therapy than after regular surgery.

Fluorouracil injections- Injections into the keloids with the combination of the chemotherapy drug fluorouracil and triamcinolone have been used when other measures have not been successful.

Dermabrasion: This procedure involves using a specialized tool to rub away the top layers of skin, much like a sanding machine might.

Scarring's tendency to discolor can be lessened if skin layers are peeled away.

The procedure known as microneedling is also referred to as collagen induction therapy.

It functions by making several, little incisions within a scar using a specialized tool.

In most cases, these wounds recover in two days, and the scar develops new collagen.

A protein called collagen helps to give our skin strength and flexibility.

Microneedling encourages the exfoliation of old skin cells, particularly skin cells that have been stained by too much pigment, so that it might lessen the scarring-related discoloration.

To reap the greatest advantages, multiple treatments are often needed every four to six weeks.

It is significant to emphasize that the primary goal of microneedling is not to reduce skin discoloration; alternative focused therapies for the condition may be more effective.

Chemical Peels: This procedure exfoliates the skin's surface by using strong concentrations of glycolic or salicylic acid.

By doing this, it might lessen the discoloration brought on by scarring.

A licensed professional should only provide this treatment.

Prevention of Keloid scars

Avoid body piercings, tattoos, and unnecessary surgery if you are prone to keloids.

Following these operations, keloids could form.

After a small skin injury, begin treating it right away to avoid developing keloids.

This could hasten healing and reduce scarring.

The following advice for treating the area could aid in stopping the development of keloid.

After surgery, compression to the area can aid in preventing the growth of a new keloid.

To prevent a keloid or maybe generate a smaller keloid, patients wear pressure jewelry or clothing for six to twelve months.

Inflammation, which appears to be a factor in the development of keloid, can be decreased by administering anti-inflammatory steroid injections into a fresh scar.

To lessen the chance of keloid development, silicone sheets, which resemble bandages without the gauze pad, can be put to fresh wounds.

These special sheets do not, however, lessen the size of keloids that already present.

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