Keloids have been a problem for people for at least the last four thousand years. They were first described by Egyptian physicians around 1700 BC, and have appeared throughout history in medical documents and journals since then. Some cultures, such as the Olmec in Mexico and the Nubia-Kush of Sudan intentionally provoke keloid scarring on their faces and bodies as means of decoration.
Keloids are a kind of scar which results in an overgrowth of tissue in the place where the skin has healed. A keloid is a firm or rubbery lesion, or it can appear more like a shiny hard nodule. It can be several different colors: flesh-colored, pink, red, or dark brown. They are found most often on the ear lobes, the breastbone, the shoulders and upper back, and any place where scar tissue can be found. Keloids are benign and non-contagious, but can cause discomfort and other problems for people who have them. They are not the same thing as hypertrophic scars; those are raised scars on the site of the original wound. These do not spread, and sometimes even reduce over time.
The symptoms of keloids include raised tissue that is usually accompanied by severe itching, sharp, needle-like pains, and changes in texture, although the degree of all these depends upon the person and the severity of the keloids. If they get very bad, they can even restrict a person’s movement because of the effect they have on the skin. Keloids expand over the skin in growths that look like reaching claws.
Keloids form inside scar tissue, resulting from an overgrowth of collagen. Collagen is production is one way in which the body tries to heal itself from a wound, but if the body produces too much, the scar tissue may form a lump many times the size of the original scar. This lump is the keloid. They usually occur at the site of an injury, but they can also appear spontaneously, with no apparent cause. They have also been known to arise from piercings, or from severe acne scars or chicken pox scars. Other causes may be an infection at the site of a wound, repeated injury to an area, tension to the skin during the healing process, or having a foreign body inside a wound.
Men and women are equally affected by keloids, though some studies show that young females are more susceptible to keloids because of frequent earlobe piercing. Children can also develop them, as they are often the result of skin traumas such as bug bites or scratches, of which children get plenty. If you have darker skin, you are fifteen times more likely to experience keloids than a person with lighter skin, and some studies indicate than anyone with any degree of African blood is more at risk than most people. Keloids can also appear when you have razor bumps on your skin, but decide to shave, anyway. The bumps can become irritated or infected, and keloids can form. It is a good idea to avoid shaving for a few days to allow the irritation to subside so that the bumps do not become infected.
There are no treatments for keloids that experts find to be a hundred percent effective. Keloids can be treated with certain gels, such as Contractubex or Hexilax. Both of these gels were developed to treat thyroid scars but are now used for burns and post-surgery scars, too. These work better the earlier you begin treatment on the keloids, and if you start it early, this treatment has been proven to have very good results.
These gels have become the first choice of treatment for new keloids. Another way to treat keloids is with the use of wound coverings made from silicone gels or silastic. They have been shown to reduce keloid prominence over time. Steroid injections into the keloid can also reduce the size of the keloid, as well as ease the uncomfortable side effects of keloids. As with other treatments, these work best at the beginning, when you first suspect that a keloid may be forming. The problem with these injections is that it is not easy to inject a needle into the hardened keloid tissue, and each injection may require general or local anesthesia. Compression bandages can be applied to the scarred area for a period of several months or even a year, and this can reduce the size of the scars. This is also a very effective treatment for new scars.
Other treatments for keloids include cryosurgery, which is most appropriate for small keloids or those that appear on fair skin, because the process bleaches the skin. This process freezes the skin and causes sludging of the blood beneath, essentially creating localized frostbite. Cryosurgery is often used in conjunction with cortisone injections. Radiation, too, is effective at levels that don’t penetrate the body enough to damage internal organs. Radiation can be effective in preventing keloids if it is used after surgery and after a wound is healing.
Another option for deeply ingrained or widespread keloids is surgery. Surgery for keloids is very complex, though, since the wound inflicted by the surgery itself can also provoke the growth of keloids. If that happens, these new keloids could be worse—larger and deeper—than the original ones the surgery had intended to treat. This can be helped by the use of corticosteroids injected into the lesion, or the addition of plastics to the skin to minimize skin tension during healing. Laser therapy is considered to be an alternative to traditional surgery for keloid removal.
The most important thing about keloid treatment is not to get one. If you know you are susceptible to keloids—either you’ve had them before or they run in your family—avoid any skin trauma. Do not get tattooed or pierced, and avoid any surgeries you do not absolutely have to have. Keloids are treatable, but not curable, so it’s better not to get them at all if it’s possible.
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