Keloid scars are firm, smooth, and dense growths that form on a healed wound. These are formed if there is any abnormality during the healing process. Keloid scars spread outside the area of the wound. . Hypertrophic scars form a thick layer of skin over a wound.
Clotting begins to minimize blood loss after an injury to the skin. Consequently, the collagen and fibrous tissue form the scar tissue. This helps to repair and protect the wound. However, in some cases, this scar tissue grows excessively and forms a smooth, hard growth called a keloid.
Generally, keloid scars grow beyond the original wound. They may be itchy. Moreover, they may worsen in appearance and become painful if left untreated.
Appearance – round, oval, or oblong with irregular margins; some may have crab claw-like configurations at the borders.
A hypertrophic scar forms if the body overproduces collagen during the healing process. Consequently, the excess collagen may lead to an elevated scar. Usually, a hypertrophic scar does not develop beyond the boundaries of the original wound.
Moreover, the elastic strength of the scar helps to increase the strength of the injured skin by cross-linking collagen fibers.
. In most cases, they remain elevated above the wound if left untreated.
DO: Inform your doctor if you have a tendency to develop keloids and hypertrophic scars
DO: get your wounds treated at an early stage
DON’T: Ignore any injury or wounds
DON’T: Go for any procedures such as tattooing or any surgery without a Dermatologist’s opinion.
The treatments act by suppressing the inflammation. Additionally, the treatments aim to inhibit collagen and fibrous scar tissue production.
Generally, keloids follow the lines of injury. However, they do not stay restricted to it and can spread to normal skin as well. They tend to be itchy, tender, and painful. Moreover, they are capable of interfering with limb movement if present at joints. Keloids are difficult to treat, prone to recur, and never regress spontaneously.
Although they are difficult to treat, there are many treatment options to remove or at least improve the appearance of keloid scars. Steroid injections in the keloids are most effective for small keloids. However larger keloids require a combination of surgery and other treatments. Your doctor will determine the course of treatment based on the location of the keloid, its size and depth, and the age of the patient.
The most common treatment for keloids is injecting corticosteroids directly into the scar. The tissue doesn’t absorb the drug well enough through the skin to be effective. Hence, injections are more effective than topical applications.
This method uses the application of extreme cold in form of liquid nitrogen to keloids resulting in freezing and destruction of keloidal tissue.
Pressure dressings can be used over the injury site within a month of the wound. This may prevent keloid formation. This treatment can also help to reduce keloid if formed already.
They help in fading out the scar. They also make the skin tone even so that the scar matches the skin color. The patient wears the silicone sheets daily for over six to ten weeks for best results.
They are natural or synthetic substances that help regulate the immune system. They reduce collagen production and cause the deactivation of fibrous tissue.
Retinoids can help regulate the production of collagen and other skin cell factors. Hence, they are able to counteract the dysfunctional process in keloid stem cells. One can use them both topically or orally.
In addition to inhibiting collagen and fibroid tissue production, they also reduce vascularity, pliability, height, and width of the lesions. Furthermore, injections of calcium channel blockers like verapamil given after surgical removal of keloids can also help cure or reduce recurrence rates.
They are anti-inflammatory and antiproliferative agents. Hence, they inhibit collagen synthesis and deposition. Additionally, they provide relief to the pain and itch associated with keloids.
Usually, surgery is reserved as a last resort, since it can itself lead to scar formation. Surgery can be followed by corticosteroid or verapamil injections and silicone sheeting to decrease the chances of recurrence.
The lasers such as IPL are used in the early-stage to reduce inflammation and vascularity of the keloid. The CO2 laser is used in keloid for its ablation, to regularise collagen formation, and also can be used as a drug delivery system.
When given locally, this relaxes the muscles and reduced skin tension which is an important factor for causing keloid.
Hypertrophic scars are easy to treat and respond early as compared to keloids. Various types of hypertrophic scars require various types of treatment.
Factors such as
Are the key determinants to deciding the method of treatment.
silicon-containing creams are used as an adjuvant treatment to other procedural treatment
This is mainly used to break down the collagen. Usually, the procedure applies different pressure to each part of the body.
Silicone gel sheeting is one of the least fussy methods. Moreover, it is a simple and effective method. Usually, patients need to apply it once a day and keep for 12-23 hours for 4-6 weeks.
The dosage depends on the size of the scar.
This treatment improves skin color and texture. lasers such as IPL and CO2 can be used.
Keloid scars are firm, smooth and dense growths that form on a healed wound. Keloid scars spread outside the area of the wound. Hypertrophic scars are formed if there is any abnormality during the healing process. Hypertrophic scars form a thick layer of skin over a wound.
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"Lota of improvement in my scars, Doctors and staff is very friendly and helpful. Dr. Shah gives detailed explanation about treatment and precautions to be taken. I'm satisfied with the treatment and good to go "
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