Keloid scar: Description, Causes and Risk Factors:The wounds of some people undergo aberrant healing, resulting in the formation of keloids or hypertrophic scars. Keloid scars are actually thick, puckered, itchy clusters of scar tissue that grow beyond the edges of a wound or incision and rarely regress. Keloid scars are sometimes very nodular in nature, and they are often darker in color than surrounding skin.The cause is unknown, although there are various theories, including:Dysfunction of the extracellular matrix which controls growth factor activity.
Abnormalities in collagen turnover.
An inherited abnormal response to dermal injury.
An immune reaction to sebum.
In the early stages, it is composed of type 3 collagen, and later on it is replaced by type 1 collagen. Keloid scarring typically occurs in the aftermath of an injury that has broken skin. However they sometimes occur on otherwise normal, healthy skin too. Keloid scars are sometimes mixed up with hypertrophic scars - however, the latter only develop on wounds and never extend beyond the site of the wound. A keloid scar, on the other hand, can extend and change shape as well as texture. Keloid scars are also often extremely itchy, and some can be painful too. They sometimes also restrict movement, as they do not stretch as easily as healthy skin.The reason why some people develop keloid scars is as yet unclear. Various theories have been put forth, but none have been scientifically verified as yet. We do know that women seem to develop keloid scars more frequently than men, and that dark-skinned people are also more likely to develop them. There seems to be a hereditary factor at work too - to some extent, the problem is passed down from generation to generation. There is also a higher chance of keloid scar tissue developing on certain parts of the body, namely the upper torso.Although keloid scars are not contagious or cancerous, most people want to have them removed because of the resultant itching, pain, restricted movement, and the unpleasant appearance of the scars.Symptoms:Signs & Symptoms:The scar may be tender, painful, itch or produce a burning sensation.
There is usually a history of trauma that may be accidental, surgical or cosmetic.
Burn scars or infected lesions, including acne, are more likely to form keloids.
Diagnosis:The diagnosis is made clinically; investigations are not required.Assess the patient's concerns and the impact of the scars on their life.Check if the scar reduces mobility, e.g. near a joint.Treatment:Unfortunately, there is no known keloid scar treatment. Treatment options may include:Local steroids: Intralesional steroid injections (with triamcinolone) are a mainstay of treatment and prevention - reviews suggest that it improves the majority of scars.Pressure or occlusive dressings: These are used both for treatment and prevention, with minimal adverse effects, provided they are practical and acceptable to the patient. They must be used for 12-24 hours daily for several weeks or longer.Silicone gel - this is applied as topical gel or a gel-impregnated sheet.
Self-adhesive polyurethane scar reduction patches are also suggested.
Other pressure dressings may be used.
Surgery: Surgery is another option, but there is a 50% recurrence rate, which is why most people prefer to avoid surgery. However, when combined with other treatments, surgery is more successful. Some of the treatments that can be used either by themselves or in combination with surgery are compression bandages and silicon gel dressings.Another option is laser treatment, but this treatment is rather superficial and does not have a lasting effect. Radiation therapy and steroid injections are also used quite effectively, but only in certain situations. This is something your doctor can guide you on. Various natural remedies and creams are also recommended for keloid scar removal. These often make use of ingredients such as vitamin E oil, calendula, and grapefruit extract. However, most of these treatments either have only a short term effect or work merely as moisturizers and skin softeners.NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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