When skin is injured, the body may produce fibrous scar tissue known as Keloid. The body may greatly overproduce this tissue depending on factors such as the location of the injury and the genetic predisposition of the patient, Common skin injuries that may result in Keloids include:
- acne scars
- surgical incisions
- chicken pox
- piercings (common)
Keloids, unlike hypertrophic scars that shrink and fade over time, may present as flesh coloured, red, or pink in colour and may be itchy. Keloids are usually raised and may cause minor discomfort if located in an area that is prone to re-injury,
Although they do not present any major health risk, when this overgrowth is substantially larger than the original wound people often seek effective treatment to reduce the size of the Keloid.
The goals of therapy for Keloids may include:
- Relief of symptoms (pain or pruritus)
- Reduction of the scar volume
- Functional improvement
- Cosmetic improvement
The following treatment options are among the most common
- Surgery is usually effective when properly dressed and treated with subsequent corticosteroid injection. Sometimes may produce a larger Keloid or re-growth of similar size. Safe and not painful as local anesthetic is used.
- Laser therapy focused beams of light energy released in the form of Photons. May reduce or flatten the lesion. Fractional, erbium:Yag 2940nm lasers are very effective in the reduction of Keloids as they specifically target the affected area and do not disturb normal cells around the injury area. Safe and not painful.
- Cortisone Injections (intra-lesional steroids). These can flatten the lesion but also cause redness and some vascular alteration which subsequently would be treated with a laser. safe and not painful.
- Silicon Gel sheeting (bandaging).
- Cryotherapy may flatten the Keloid but often results in a darkening of the area. Not painful but mixed results are seen.
Other potential therapies include radiation therapy, flourouracil injections, and Interferon injections however these are not in common dermatological use. In some cases, a skin biopsy may be ordered by your doctor to exclude potentially serious conditions that mimic Keloids or hypertrophic scars. A person with a history of Keloids should avoid elective surgery and seek immediate medical attention if injured, even with minor scratches or burns, to avoid keloid scars.