What are keloids?
Keloids are raised scars that form on the skin and has a smooth top and is sometimes purplish pink in colour. Fibrous tissues formed over the wound to protect the injury and repair it, grow excessively beyond the normal margins of the scar, materializing into hard and smooth growths known as keloids. They most commonly form on the chest and shoulders. Keloids are not harmful but can cause cosmetically disturbing.
Historical background The first historical record of the abnormal scar formation of the keloid is found in the Smith papyrus. The surgical techniques were recorded around 1700 BC in Egypt. The word keloid means ‘crab claw’ or ‘crab pincers’ conceived in 1806 by Baron Jean-Louis Alibert. He attempted to explain the lateral expansion of the scar.
Symptoms As an overgrowth of scar tissue, the following symptoms may be noted:
- ■ Area is ridged, raised, lumpy and dome shaped
- ■ Itchiness
- ■ Tenderness
- ■ Painful to touch
- ■ Large and unsightly
- ■ Benign formations
Causes of keloid scarring Keloid scarring could be contributed by skin injuries associated with:
- ■ Earpiercing
- ■ Chickenpox scars
- ■ Burns
- ■ Surgical cuts
- ■ Vaccination sites
- ■ Burns
Formation of keloid scarring is associated with erratic cellular signals that control cellular growth. People with darker skin are susceptible to the development of keloid though it can occur in all skin types. There is also a hereditary tendency for keloid development.
Treatments for keloid scarring Keloids can prove resistant to treatment and most decisions for keloid removals are due to its anatomical location and extent of irritation of the lesion.
Intralesional steroid injections Intralesional corticosteroid injections are given at intervals of 4 to 8 weeks ,administered into the lesion directly or just to adjacent skin. There are several advantages of the intralesional steroid injection:
- ■ Minimal skin atrophy
- ■ Bypasses the thick stratum corneum
- ■ High concentrations of delivery to affected site
Satya Skin Hair Clinic uses triamcinolone injections safely and effectively on its patients. With this the recurrence of keloid scarring is dropped to about 50%.
Pulsed laser Pulsed dye laser effectively flattens the keloid with no adverse effects. Clinical outcomes are profound with a combination of intralesional steroid injections and pulsed dye laser.
Surgery Surgical technique of the keloid is very meticulous and is conducted along with other treatments such as intralesional steroid injections, pressure dressings and radiotherapy.
Radiotherapy Radiotherapy is generally recommended for post surgical keloid scarring.