- by Dr. Asmita Dhekne Chebbi
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- Nov 24 2017
KELOID: A RAISED SCAR
It is a type of raised scar that grows much larger than the wound that caused the scar and also spreads. Not everyone who gets a scar develops a keloid. Keloids that form when people do not injure their skin are termed as spontaneous keloids. It usually takes time to disappear. Once it begins, a keloid can enlarge slowly for months or years. The sizes and shapes of keloids vary. As the scar grow they may feel painful and itch. A keloid that covers a joint or large area can decrease a person’s ability to move that part of the body.
As wounds heal, scar tissue forms, which at first is often red and somewhat prominent. Over several months, it usually becomes flat and pale. If there is a lot of tension on a healing wound, the healing area is rather thicker than usual. This is known as a hypertrophic scar.
No one treatment is best for all keloids. To give their patients the best results, dermatologists choose a treatment based on the patient’s age, type of keloid, and other considerations.
Causes and Symptoms of Keloids
During normal wound healing process, fibroblasts (a type of cell in connective tissue) synthesize the protein collagen, which provides structural support for the wound and plays a key role in each phase of wound healing. Keloids form when the fibroblasts produce far more collagen than what is produced during normal wound healing. Collagen synthesis in keloids is about 20 times greater than in normal, unscarred skin (and three times greater than in hypertrophic scars).
Other biological factors also contribute to keloid development, including the overproduction of certain growth factors and glue-like proteins.
Keloids can develop from most types of skin injuries, including:
• Surgical cuts
• Acne and chickenpox blemishes or scars
• Body or ear piercings
• Vaccination shots
Keloids form over the general site of the injury and may appear flesh-colored, red, or pink. Some keloids are smooth, while others are nodular (lumpy) or ridged. A keloid may tan darker if exposed to the sun during the first year of formation. These symptoms may worsen if the keloid is irritated by friction against clothing or other materials.
Treatment options and considerations
• Corticosteroid injections to reduce inflammation
• Moisturizing oils to keep the tissue soft
• Using pressure or silicone gel pads after injury
• Freezing the tissue to kill skin cells
• Laser treatments to reduce scar tissue
• Radiation to shrink keloids
Initially, your doctor will probably recommend less-invasive treatments, such as silicone pads, pressure dressings, or injections, especially if the keloid scar is a fairly new one. These treatments require the frequent and careful application to be effective. However, keloids tend to shrink and become flatter over time, even without treatment.
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