Keloid scar: photo, treatment

A keloid scar is the result of an overgrowth of scar tissue. It looks like a solid, smooth, hard, knotted growth, often - various shades of red. Many mistakenly call it the term "colloidal scar", which is a grammatically incorrect name.

Keloids (keloids) may begin to form as soon as they are injured, or several months later. They may be much larger than the original wound itself. Unlike other types of scars - this type of scars / scars never brightens and does not become imperceptible with time.

Keloid scar: photo

They occur on any part of the body where the skin has been damaged, but the following body parts are most susceptible to the formation of keloids: chest, shoulders, neck, knees, ankles, earlobes.

Keloid scar and hypertrophic scar - what is the difference?

Usually, after an injury, the body starts the healing process, as a result of which an ordinary flat scar is formed on the skin surface (in the place of a former wound). For reasons unknown to science, a scar may suddenly begin to thicken, i.e. hypertrophy of scar tissue occurs. Hypertrophy can be of two types, and, depending on its type, there is either a hypertrophic scar or keloid.

  • Hypertrophic scar (Fig.7-9) -
    it is formed if the hypertrophy is limited to the area and the sizes of the wound itself. Most often, hypertrophic scars begin to develop during the first two months after injury, and at the same time they quickly turn red. Sprawl occurs for up to 6 months, after which spontaneous regression usually occurs (stops in growth or even decreases slightly).

    This whole process, as a rule, takes 1 year, not more. Early treatment (injections of cortisone or steroids) can speed up the regression process.

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  • Keloid scar (Figure 1-6) -
    if scar tissue hypertrophy extends beyond the area of ​​skin damage, capturing healthy intact tissues - such a scar is called keloid. This type of scarring develops within a few years after an injury, but sometimes it can occur completely spontaneously, even without a previous injury, for example, on the chest.

    A keloid scar can grow for many years and never regresses as hypertrophic. Moreover, keloid scars often grow again if they have been surgically removed before. With hypertrophic scars this never happens (24stoma.ru).

Other symptoms of keloid scars -

Keloid scars can be either flesh-colored or red, pink or darker. They can be smooth, knotty or spherical, or simply protrude into the skin in chunks. If in the first year of keloid formation the sun's rays hit it, the scar may forever become darker than the surrounding skin. Sometimes a keloid scar causes itching, irritation or pain (and these symptoms may worsen from rubbing clothing).

Keloid scars: causes

In the process of wound healing, fibroblasts begin to actively synthesize collagen. Sometimes, for some reason, fibroblasts begin to produce collagen more than is necessary for the normal wound healing process. In this case, the scar begins to grow, forming keloid. According to studies, collagen synthesis in keloids is 20 times higher than in normal scars and scars.

Keloids can develop from various skin lesions, including -
→ surgical incisions,
→ skin wounds after injuries,
→ vaccination shots,
→ for acne (acne and pimples), chickenpox,
→ when piercing various parts of the body (including piercing earlobes).

Surgical removal of scars and scars -

It is much easier to prevent the appearance of keloid scars using special ointments or silicone patches than to treat the scars that have already appeared. Surgical treatment consists of excision of the keloid scar with a scalpel or surgical laser. Surgical removal of scars and scars by laser should not be confused with the procedure of laser resurfacing of scars. The latter is a conservative non-surgical procedure.

However, for keloid scars, surgical treatments are quite risky, because an operation may cause the formation of a similar or even larger keloid in place of the former. Therefore, if the excision is applied, then immediately after the operation all possible preventive measures are used to avoid recurrence.

→ special ointments for scars,
→ corticosteroid drugs
→ prolonged wearing of a pressure bandage or compression underwear after surgery.

Excision of keloid with surgical laser: video

Non-surgical treatments for keloids -

In addition to the surgical method of treatment, there are other treatment options that can significantly reduce the size of keloid, as well as make it lighter.

1. Laser resurfacing of scars -

This is one of the most common methods of combating scars, not only keloid, but also hypertrophic. Typically, this uses fractional lasers, argon laser, neodymium laser (YAG), CO2 lasers (carbon dioxide), pulsed dye lasers. Laser resurfacing of scars helps to make scars flatter and less red. The treatment is safe and not too painful, but usually requires several sessions.

The first video shows laser resurfacing of scars: photos before and after
On the second - laser polishing of keloids, combined with steroid injections.

2. Injections of corticosteroids -

Corticosteroids reduce excessive scarring due to the following effects:
→ they reduce the proliferation and activity of fibroblasts,
→ reduce collagen synthesis,
→ reduce the synthesis of glucosaminoglycans,
→ reduce the synthesis of inflammatory mediators.

Most commonly, triamcinolone acetonide (TAS) is used as a corticosteroid in a concentration of 10 to 40 mg. For better efficacy, corticosteroids are used in combination with other methods of scar removal (especially with cryotherapy), which reduces the risk of recurrence by 50–100%.

3. Cryotherapy -

Liquid nitrogen causes cell damage. Usually, to achieve the desired effect, spend 1, 2 or 3 cycles of freeze-thaw, lasting 10-30 seconds each. May require repeated procedures every 20-30 days. Studies have shown that the effectiveness of this method is 51-74% without relapse within 30 months of observation.

Possible side effects -
→ pain,
→ permanent depigmentation of the skin at the site of exposure.

Cryotherapy combined with steroid injections: video

4. Pressotherapy (pressure bandages) -

It has long been known that pressure has a thinning effect on the skin. The reduction in the number of collagen fibers in hypertrophic and keloid scars under pressure dressings has been proven using electron microscopy data.

Compression treatment methods include pinpoint (push-button) compression, pressure bandages, elastic bandages, special silicone-based patches ... Studies have shown that if you use plasters with silicone (Mepiform, Spenco) from the very beginning, this improves scarring in 60% patients. However, such patches need to be worn 24 hours over a period of several months, which is difficult to sustain.

5. Scar Ointment or Scar Cream -

Virtually any modern ointment for sucking scars and scars contains silicone, which (according to recent studies) creates an airtight film, which perfectly moisturizes the scars, gives them elasticity and softness. And this, in turn, is a good factor for normal healing and the formation of an inconspicuous flat scar.

An example of external means of scarring -

  • Dermatics (silicone + silicon dioxide) - in Figure 10,
  • Kelo-Kot (contains silicone + polysiloxane) - in Figure 11,
  • Zeraderm Ultra (Silicone + Vitamins E and K + Coenzyme Q10 + UV Filter 15)
  • Scargard (silicone + hydrocortisone + vitamin E),
  • Fermencol (contains collagenase of animal origin).
  • Contractubex (contains sodium heparin + onion extract + allantoin),
  • silicone patches Mepiform, Dermatiks and others (Fig. 12).

Ointment from the scars after the operation should be started to use only after the healing of the suture, that is, the complete disappearance of the crusts. Until this time, crusts can be lubricated with Panthenol, D-Panthenol, Dexpanthenol or other similar agents. Keep in mind that in no case you can not otkovyrivat crusts on their own, they must disappear themselves!

Ointment for sucking scars and scars: reviews

To use or not to use ointment or cream for scars and scars - reviews have shown contradictory results. The analysis showed that the tendency to form scars completely depends on the organism itself and its susceptibility to keloids at the cellular level.

We met reviews when people smeared scars with all possible expensive and not very expensive ointments and creams for scars, and still they had keloids. And some reviews, on the contrary, noted that they did absolutely nothing with their scars and over time they turned into barely noticeable white strings of scars. Worse that you will use any ointment for resorption of scars and scars - definitely will not, and in any case, the use of these funds still reduces the risk of coarse scars and keloids.

6. Interferon -

Recent studies have shown that the use of interferon may help in reducing the size of keloid, although there is as yet no exact data on the duration of the effect of such therapy. Currently, physicians often recommend this method as an auxiliary method of treatment. The treatment is carried out by using creams containing "imiquimod 5%" (preparations "Aldara", "Zyclara").

7. Radiotherapy -

Her try to use only in exceptional cases, because of the risk of cancer.

8. Promising methods -

Other treatments for keloid scars are currently under investigation. Direction of research:
→ use onion extract,
→ use of the drug "fluorouracil" (5-FU),
→ internal cryotherapy (freezing of scar tissue from inside the keloid itself).

9. Collogen gel Kolost from scars: reviews

Recently, other means have appeared on the market that promise to improve the condition of the skin and scars. For example, Colloste collagen gel from scars - reviews about the effectiveness of the drug for the treatment of scars as such are absent, but we analyzed the composition and mechanism of action of the drug to determine the very possibility of treatment with this drug.

The drug consists of hyaluronic acid or collagen of animal origin, and is made in the form of 7 and 15% gels, which are injected. According to the composition and the instruction itself, the drug on the contrary helps the skin to develop its own collagen. Consequently, the drug can only be shown for the treatment of atrophic scars, but not keloid or hypertrophic, in which collagen is produced and so is 20-30 times more than necessary.

We hope that our article was useful to you!

Author: editors of the portal.

Watch the video: Scar and Keloid Management - Andrew Vardanian, MD. UCLAMDCHAT (September 2019).

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