Scars are not always a simple reminder of past wounds; some become a real medical challenge and a great therapeutic challenge. This is the case of hypertrophic and keloid scars, a abnormal scar tissue response that after a skin injury grows uncontrollably, significantly affecting your appearance.
Although there are various treatments, is it really possible to eliminate them completely?
From the García-Legaz Dermatological Institute, we want to talk to you about the real possibility to improve a keloid scar, as well as explain to you what is, what are your characteristics and factors cause it.
What is a keloid scar?
In normal healing, the fibroblasts (the cells responsible for collagen production) are activated to repair the wound, and then deactivated once the scar has closed the injury.
However, in the case of the keloid scars, this answer is excessive, causing a overproduction of collagen which continues to accumulate even after the wound has healed. This results in a scar that is not only more prominent, but also grows beyond the limits of the original wound.
A keloid scar can appear anywhere on the body after a skin injury and is characterizes by:
- Elevation: surface bulging which can be very prominent on the surrounding skin, its contour is usually irregular and does not always follow the line of the original scar.
- Texture: its consistency can be firm or rubbery, usually thicker than normal skin. It has a surface smooth, shiny and hairless.
- Discomfort: can cause itch, tightness or even a feeling of pain, especially if they are subject to friction or pressure.
- Coloration: can vary from a deep red until brown or purpleOver time and after sun exposure, they may darken further.
Causes and risk factors
Although the exact causes of this abnormal response are not fully understood, keloid formation may be influenced by multiple factors.
Know your causes and risk factors It is essential for the management and prevention of keloids, especially in people at higher risk.
Genetic predisposition
People with family history of keloids are at greater risk of developing these scars. In addition, certain populations, such as those of African descent African, Asian and Latin present a greater predisposition.
The inheritance It is one of the most influential factors in the development of keloids.
Age
Keloids are more common in young people, especially in those under 30 years of age.
This could be due to the increased cellular activity characteristic of this stage of life, when the skin produces more collagen, which could explain its higher incidence in this age group.
Skin type
People with darker skin are at higher risk of developing keloids.
This is partly because skin cells (melanocytes) in these people are more active, which can influence the formation of this type of scars.
Location of the lesion
Certain areas of the body are more prone to develop keloids, such as:
- Chest and cleavage
- Shoulders
- Upper back
- Central part of the abdomen
- Cheeks
- Ears
These areas may be more exposed to stress and movement, which can contribute to the formation of keloids.
Type of injury
The surgical incisions have the potential to develop keloids in predisposed individuals.
However, these particularly susceptible individuals can trigger the formation of keloids with minor injuries such as cuts, abrasions, punctures, burns, bites, and severe acne.
Keloid Scar Removal: Is It Possible?
They exist various treatments which can significantly reduce the size of the scar and improve its appearance, but the total and definitive elimination of a keloid is a challenge considerable.
When should a hypertrophic keloid scar be treated?
The sooner the better, the longer the scar is, the more difficult the treatment will be.
To improve keloid scars, we need several sessions spaced a few weeks apart, so the sooner the initial evaluation is performed, the more time we have.
Possible treatments
The treatment of keloid scars is challenging due to their strong tendency to reappear.
The focus of treatments for keloid scars is usually on reduce its size, relieve symptoms and improve your appearance, often combining several methods to achieve the best results.
Depending on the magnitude and age For keloid treatment, dermatologists often employ some of the following options:
- Corticosteroid injections and antiproliferatives: reduce the inflammation and the size of the keloid, softening the scar, but not ensuring its complete removal.
- Topical treatments: Creams with corticosteroids, retinoic acid, or other ingredients help reduce the risk of inflammation, soften scar tissue and modify growth of the keloid.
- Laser treatment: vascular laser in the inflammatory phase, non-ablative fractional laser (FRAX 1550 by Nordlys), ablative fractional laser (CO2 laser) in stable phase and other combinations of lasers can precisely treat scar tissue without damaging the surrounding skin, improving the texture and color and assisting in complete scar removal. Laser-assisted drug delivery can also be performed. (LADD: Laser Assisted Drug Delivery)
- Surgical removal: removes the tissue scarring, but with very high risk of recurrence, which is why it is usually avoided and reserved for very specific areas and always combined with other treatments.
Keloid prevention
The prevention of this type of scars is essential, especially for those with a family history or who have developed keloids previously.
- Avoid unnecessary injuries: Minimize procedures that damage your skin, such as tattoos or cosmetic surgeries.
- Early wound treatment: Keep wounds clean and use silicone dressings or gels to reduce the risk of abnormal scarring.
- Pressure on the scar: Apply pressure with bandages or compression devices to prevent their formation.
- Sun protection: Protect your skin on recent scars to prevent darkening and reduce the risk of irritation.
In conclusion, although completely removing a keloid scar can be complicated, there are effective treatments. Our specialists in clinical dermatology are committed to offering you customized and efficient solutions, with the help of the latest technology, regardless of the severity of your case, to combat these unsightly scars and improve their appearance.
Literature
- Cintrôn-Machón, G., & Poveda-Xatruch, J. (2008). Keloid scarring. Costa Rican Medical Certificate, 50(2), 87-93. https://www.scielo.sa.cr
- Salem, C., Vidal, A., Mariangel, P., & Concha, M. (2002). Hypertrophic scars and keloids. Surgery notebooks, 16(1), 77-86. http://revistas.uach.cl
- Andrades, P., Benítez, S., & Prado, A. (2006). Recommendations for the management of hypertrophic and keloid scars. Chilean Journal of Surgery, 58(2), 78-88. https://www.scielo.cl
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