Keloid  Scars

Keloid Scars are firm rubbery and nodular scars which are unattractive. They usually occur in areas of previous surgery, trauma burns, acne and skin abrasions. When the original wound heals it heals with formation of collagen 3 fibers later converting to collagen 1 fibers with time. Usually they extend beyond the margins of the injury.

Sometimes keloids occur in ears. this can follow a simple piercing.

It is very common to get keloids in the chest area. especially in the middle following heart surgeries.

Hypertrophic scar on the other hand does not grow out of the skin without control. It is thicker than a normal scar.

They are reddish itchy and painful. Usually shiny layers of stretchy skin found adjacent to it. Commoner on bony protrusions such as sternum, jaw line or other areas of stress like breasts.

The hypertrophic scars are usually red elevated areas with prolonged chronic inflammation and excess collagen formation. Usually they do not extend beyond the borders of the original injury. Usually occur in the same body areas as the keloid scars. 

Keloid scars are commoner in darker skin. They are also commoner between the ages of 10 and 30.

Treatment consists of

  • Compression therapy
  • Intralesional steroid injections
  • Intralesional steriod and 5 fu injections in combination
  • Cryosurgery
  • Radiation therapy
  • Laser therapy
  • Botox , verapamil, bleomycin and Inteferon intralesionally

Most successful treatments include excision with 5fu and triamcinolone injections combined with IPL and co2 laser  and diode laser therapy with fat transfer to underlying skin for stem cell treatment.

Above case was caused by ablative co2 fraxel and was treated over a period of six months to achieve the improvement as seen in the right side picture.

To obtain the best scars with surgery proper skin closure with less tension is the best preventive measure. Patients are advised to avoid sunexposure, alcohol intake and smoking during the preop and postop periods. Arnica is a wonderful therapy for wound healing. In addition to that three months of antioxident supplements (Same used for Antiaging therapy) is recommended.

For the worst keloids a stemcell-fat graft under the scar can be performed and then excision done in about a month followed by the above regimen to minimize scarring.

For regular scars the best treatment is carbon dioxide laser resurfacing.

Treatments are done once a month and improvement of the scar can be seen as above after about six months. This treatment is usually combined with specially formulated skin creams.  Usually it is a combination of keloid and wart cream in the morning and noon time and night cream to be applied at night.

Above picture shows resurfacing of a nasal scar with carbon dioxide laser resurfacing.  In our clinic we perform these laser for a very affordable price.

Some of the recent data suggest that larger keloids can be removed under local anesthesia without suturing and then allowed to heal with intermittent injections without suturing for better results.

In the above case the keloid had been removed with co2 laser and allowed to heal with intermittent steroid injections. The results on the right are after ten months.

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