Treatment of Keloid and Hypertrophic Scar

The keloid is an unusual and aesthetically undesirable as healing of skin, characterized by being a exuberant scar thick, with raised and reddish color. The term keloid is of Greek origin and means something like "tumor aspect." The name is quite appropriate, since the keloid is even a benign tumor.

Keloid and hypertrophic scar
Keloid and hypertrophic scar

The keloid may arise after any type of skin injury, including common wounds, surgical wounds, acne, piercing placement and even tattoos.

It is important to note that not all big and ugly scar is necessarily a keloid. Many people looking for dermatologist's help to deal with keloid scars alleged have actually just a hypertrophic scar.

In this article, we'll explain the differences between keloid and hypertrophic scarring. We will also talk about the causes, symptoms, treatment and prevention of keloid.

Differences between keloid and hypertrophic scar

The healing of normal and desirable process is one that leads to the formation of a scar flat, clear and is limited to the site of skin that has been injured. Both keloid as hypertrophic scarring forms are abnormal wound healing, since lead to the appearance of large scars and aesthetically bothersome.

The keloid is a thick scar, with embossed, hard and reddish / purplish color. In black people, it can be very dark. It is common to itching or pain, especially in the first weeks after the event that caused the wound. However, the main feature of keloid is that it is not restricted to the injured area. The keloid scar tends to "break into" healthy areas of the skin around the wound and may continue to slowly expand over the years.

The scar does not form the keloid immediately. It takes at least 3 to 4 weeks, but in some cases can arise only after 3 to 4 months.

The hypertrophic scar, on the other hand, appears approximately 2 weeks. She, in the first months, it may even become large, reddish and with high relief, but tends to be restricted to the wound area. Another major difference is the fact hypertrophic scar regress over time, getting thinner and the similar color to the skin. In the regression phase, which can take 1 to 2 years, hypertrophic scar can be even a little deeper than the skin. In cases of large wounds and fat accumulation areas, this depression can also be aesthetically uncomfortable.

Hypertrophic scarring is much more common than keloids. If you have a scar that think to be a keloid, but after a few years it becomes much more discreet, you probably have is a hypertrophic scar that is regressing.

Both keloid as hypertrophic scarring can occur in anyone, but the keloid is much more common in blacks, mestizos or Asian origin individuals. Hypertrophic scarring occurs equally in any ethnic group.

How keloid appears?

The precise origin of the keloid is still unknown. It is known that some individuals, especially those of black and Asian ethnicity, have a greater propensity to produce chemical mediators to stimulate fibroblast proliferation. Fibroblasts are the repair cells and produce collagen that lead to scarring. The keloid is therefore a benign tumor arising from excessive proliferation of fibroblasts and collagen.

Attention, the keloid is a benign tumor, which has nothing to do with cancer. Who has keloid shows no increased risk of skin cancer.

The keloid may arise from any injury that requires healing. The most common cases are surgical wounds, but those with high willingness can create keloids from tattoos, piercing the nose or ear, chicken pox lesions, lesions caused by acne or even vaccinations, especially BCG for tuberculosis. Burns and injuries are slow to heal are those most at risk of keloid formation.

The occurrence of keloid is often unpredictable. A person can put a piercing in each ear and develop keloid only one of them.

The body sites more likely to pull the skin and muscles like the frontal area of the chest, back, shoulders and upper arms are the most frequently affected.

Despite the unwanted aesthetic effect, the keloid itself brings no major health problems, except for some degree of itching or local pain. When they are very long or come in very exposed areas such as in cases of keloids nose, face or ear, this injury can have serious emotional problems.

Treatment of keloid

Do not go thinking that you'll find an ointment for keloids that is miraculous. Unfortunately, simple and effective treatments to cure keloid not exist.

However, there are several options that, when used together, usually have a good response, with significant amelioration of scar appearance.

We will then describe briefly the treatment options most commonly used to soften the scars with keloid. Whichever option you choose, the earlier initiation of treatment, the better the results.

1. Injection of corticosteroids in injuries

The injection of a corticosteroid, usually triamcinolone acetonide, is the most used treatment to soften keloids. Its early use prevents the scars of being very extensive and also helps to make them flatter. Injections can be repeated every 1 or 2 months. A disadvantage of this treatment is that the injections are painful.

A new technique is the application of liquid nitrogen on the scar for 15 seconds before injection with corticosteroids. Thus, the pain is lower and the scar becomes softer, easier application of the product.

2. Silicone gel

The silicone gel application in the scar, especially if soon started in the early days, helps to improve your appearance. The best results seem to be obtained with blades or silicone gel plates which are to be applied as adhesives. The use of these blades is daily and should last 2 or 3 months.

3. Surgical removal of keloid

When the keloid is already old, or if conservative treatments do not work, surgery becomes the best option. Indeed, the goal is to remove unwanted scar and treat the new and early onset corticosteroids and silicone gel. This technique can succeed in more than 80% of cases. The new scar that comes usually have aspect much more pleasant than the old with keloid.

4. Radiotherapy (betatherapy)

The application of radiotherapy, which should be started on the day of surgery, is extremely effective, but its long-term safety is still uncertain. Apparently, the amount of radiation is very low and the risk of formation of malignant tumors is small. Despite being an already widely used technique, long-term studies are necessary until this treatment is considered fully safe for use in young people.

5. Fluoracil

The fluorouracil is a chemotherapy drug used to treat some cancers. Its application directly into keloid has good results, especially if associated with corticosteroid therapy and laser.

6. Laser

The application of laser in scars is still a technique with controversial results. It appears to be effective in reducing keloid relief and the redness, but is expensive and not all doctors have experience in applying it. The best results were obtained with laser in studies that this technique associated with the injection of steroids and fluorouracil.

Prevention of keloid

People with a personal or family history of keloids should avoid at all costs situations that may cause scarring. If you already have at least one keloid, the wisest course is to avoid, for example, the implementation of piercings, especially the nose or ear, which are very visible areas of the body. elective surgery or exclusively domestic purpose should be done very carefully, because the result can be catastrophic.
If surgery is unavoidable or if the patient suffers an accident with deep trauma of the skin, the best thing to do is to consult a dermatologist or a plastic surgeon so that the measures described above can be started early in order to prevent the appearance of scars with extensive keloid.

General keywords

User discussion

Site indexMedicines onlineInteresting to readCommentaries © 2012