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Keloid & Hypertrophic Scar

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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TREATMENT MODALITIES


Keloids are not harmful to general health. However, dermatologists can treat them with surgery, laser treatment or steroid injections. READ MORE

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Keloid & Hypertrophic Scar

Keloid Scars

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 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 regular margins; some may have crab claw-like configurations with irregular borders.

  • Colour - pink to cherry red.
  • Texture - soft and doughy to rubbery and hard.
  • Histopathology - composed of collagen clusters

Hypertrophic Scars

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.
These scars may thicken initially but they eventually subside. However, they always remain elevated above the wound.

  • Appearance - raised above the wound, does not cross the borders of the wound, radial growth.
  • Colour - pale.
  • Texture - flexible.
  • Histopathology - composed of collagen clusters and fibrous connective tissues.

Do & Don't for Getting Keloid & Hypertrophic Scar

DO: Consult a doctor who specialises in treating patients with ethnic skin.
DO: Keep realistic expectations from the treatment.
DO: Use a broad spectrum sunscreen daily.
DO: Use face washes that have glycolic or salicylic acid.

DON’T: Leave the house without sun protection.
DON’T: Ignore initial stages of any skin condition.
DON’T: Scrub your skin too roughly.

 

Treatment Methods

Keloids:

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. Because of these reasons, 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 into the scar 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.

  • Corticosteroids:

The most common treatment for keloids is injecting corticosteroid 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.

  • Cryotherapy:

This method uses liquid nitrogen to freeze and destroy the keloid scar.

  • Compression therapy:

Pressure dressings can be used over the injury site within a month of the wound. This may prevent keloid formation.

  • Silicone sheeting:

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 half an hour fover ten weeks for best results.

  • Immunomodulators:

They are natural or synthetic substances that help regulate the immune system. They reduce collagen production and cause the deactivation of fibrous tissue.

  • Retinoid:

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.

  • Calcium channel blockers:

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.

  • Antihistamines:

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.

  • Surgery:

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.

 

Hypertrophic Scars:

Hypertrophic scars can easily be treated however keloids are persistent. Various types of hypertrophic scars require various types of treatment.

Factors such as

  • Location
  • Depth
  • Size
  • Age
  • Previous treatment and response

Are the key determinants to deciding the method of treatment.

  1. Topical steroids:

    Topical steroids are used for treatment of many skin issues, mainly eczema, hypertrophic scarring, and contact dermatitis. Topical steroids are mainly in the forms of creams or ointments. Moreover, they are available in different strengths of dosages. These help reduce the scarring.

  2. Compression therapy:

    This is mainly used to break down the collagen. Usually, the procedure applies different pressure for each part of the body.

  3. Silicone gel sheeting:

    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. After the initial application, it will not bother you further and is extremely easy to use.

  4. Intralesional corticosteroid injections:

    The dosage depends on the size of the scar.

  5. Laser therapy:

    This treatment improves skin color and texture.

  6. Over-the-counter treatments:

    These include a combination of hydrocortisone, vitamin E, and silicone, various emollients (creams and oils).

  7. Polyurethane or silicone scar reduction patches:

    Polyurethane patches are basically clear as well as self adhesive. They aid in the healing of the scars. Moreover, they reduce the prominence and the colour of the scar.

  8. Oral or topical tranilast:

    These help inhibit collagen synthesis.

  9. Antiangiogenic factors:

    These include vascular endothelial growth factor (VEGF) inhibitors like bevacizumab.

  10. Phototherapy:

    Photodynamic therapy (PDT), UVA-1 therapy and narrowband UVB therapy.

  11. Surgery:

    Invasive measures can be used to reposition or decrease the width of the scar. Although, new scars form instead of healing the old scar completely, which takes more than a year to heal.

Important Announcement

Covid-19

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Video Calling Protocol
Hello Sir/Mam,

Clear Skin &HairMD team is pleased to offer ONLINE VIDEO COUNSELLING facility to to help patients with basic counselling for their skin and hair ailments, especially in the trying times when social distancing has become a necessity.

Our Doctors, will discuss your queries related to Skin & Hair Problems & guide you with basic information on medication and care

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  3. Video Counselling session duration - 15 min
  4. Consultation Fee for each session - Rs 700 (Payment Details are shared below for your reference)
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  8. Medicines will be prescribed as per the latest Medical Council of India guidelines for Telemedicine (March 2020) and sent over email and WhatsApp,
About Doctors

Dr. Dhananjay Chavan

Clearskin is spearheaded by Dr. Chavan, a certified dermatologist with over 30 years of experience. He has successfully treated patients with different dermatological problems.
He is the Medical Director and the driving force behind ClearSkin.
He completed his Masters in Dermatology from the historic B. J. Medical College Sassoon Hospital, Pune. He is a visiting faculty at the Department of Dermatology, Krishna Institute of Medical Sciences, Karad.
He is very passionate about all types of cosmetological and dermatological procedures and is strongly recommends a holistic approach for all types of skin and cosmetological problems.

Dr. Chavan is one of the leading dermatologists in India, and is well known internationally as well.

Dr. Sachin Pawar

Dr. Sachin Pawar is a highly qualified hair transplant consultant and surgeon with more than 17 years of industry experience. He completed his post graduation from Krishna Institute of Medical Sciences KIMS, Karad. He has been associated with Dr. Dhananjay Chavan since the past 10 years. He has relevant experience in the fields of dermatology, hair transplant and surgery. He has an associate member of International Society of Hair Restoration Surgery (ISHRS).

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Timeline for Keloid & Hypertrophic Scar

Keloid scars form 3-4 months after there is damage or injury to the skin. They stop growing after a while. In fact, proper post-injury care can help prevent keloids. Generally, it is better to avoid tattoos, body piercings or cosmetic surgery, if you belong to the high-risk category.

Hypertrophic scars start forming 6-8 weeks after the injury. Usually, they subside after a period of 12-24 months. However, it is ideal to treat these scars in the initial stages as the scar tissue will be more responsive to the treatments.

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Do & Don't for Getting Aging

DO: Consult your dermatologist before trying any product or treatment
DO: Use broad-spectrum sunscreen to prevent photodamage.
DO: Maintain a healthy skincare routine.
DO: Drink 2-3 litres of water daily.
DO: Eat a healthy & balanced diet

DON’T: Use sulphate and petroleum jelly based skin care products.
DON’T: Use skincare products that don’t suit your skin type.
DON’T: Leave the house without sun protection.
DON’T: Smoke and drink.
DON’T: Overuse anti-ageing products.



We are working on the content. For more information contact
Our patient support team on the number given below.
Kindly co-operate with us.

Call : +91-7498 906 403

Do & Don't for Getting Dark Circles

DO: Use a broad-spectrum sunscreen.
DO: Use hats, scarves, and sunglasses.
DO: Eat citrus fruits.

DON’T: Avoid overexposure to the sun.
DON’T: Don't over-exfoliate.
DON’T: Avoid using home remedies.