Keloid is an overgrowth of scar tissue that develops around a wound with often claw like extensions. The cause is unknown.  Keloid and hypertrophic scars are more common in people of color. Those who are prone to developing keloids should avoid piercings, tattoos and unnecessary surgery.  Various treatments are available to help improve the appearance.

What is a Keloid Scar vs a Hypertrophic Scar?

Keloid is an overgrowth of the scar tissue that develops around a wound, usually after the wound has healed. A keloid scar is sometimes confused with a hypertrophic scar. However, keloid usually grows beyond the borders of the original wound whereas in a hypertrophic scar the tissue stays within the wound border.

When first coined in 1806, the original term was “chéloïde”, taken from the Greek word ‘chele’ which means crab’s claw. This refers to the way the keloid grows sideways into the normal skin.

What causes a Keloid?

The exact cause is unknown. It can develop as a result of acne and boils, body piercings, burns, lacerations and surgical wounds. Infection increases the risk. There seems to be a problem with cells called fibroblasts which are responsible for the production of scar tissue (collagen). It is not known whether there is something wrong with the fibroblasts themselves or whether there is a problem with the chemicals which control their activity. Hormones, problems with the immune system and genetic factors have all been suspected of being involved. ‘Genetic’ means that the condition is passed on through families by special codes called genes. Each cell of your body contains chromosomes which are made up of many genes.

Who gets Keloid and Hypertrophic Scars?

Keloid scars are more common in people with darker skins, especially African-American races and those with Blood Group A. The peak age is 10-30 years and keloids are less common at the extremes of age. Studies of African people have shown that 6-16 out of a hundred develop keloid. Half of people with keloids will have other members of the family who have also developed keloids.

What are the Signs and Symptoms of Keloid?

Keloids typically start to develop about three months after the original skin damage although it can take up to a year. The first thing you will probably notice is that rubbery scar tissue starts growing beyond the borders of the original damage. It may become tender, itchy, painful or produce a burning sensation. Sometimes keloid develops without any apparent skin injury, although most people can identify a cause. The common areas are the breastbone, shoulder, earlobe and cheek. Keloid growing over a joint can restrict movement. In time, the original red color changes to brown or becomes pale.

Growth continues for a few weeks to a few months. The growth is usually slow but occasionally there is rapid enlargement over a few months. Once they stop growing most keloid scars remain the same size or get smaller. Hypertrophic scars tend to regress over time, becoming flatter and softer.

How are keloid and hypertrophic scars diagnosed?

They are diagnosed by the medical history and the appearance of the skin.

What is the treatment for keloid?

Both keloid and hypertrophic scars may shrink over time but rarely disappear completely. If the scar is visible, as on the face, arm, upper chestwall, this may cause one great distress. At Aesthetic Creations we offer non-surgical treatment options: Steroid Injections, using Triamcinolone, steroid impregnated pads and occlusive silicone pads which can help significantly improve the appearance.

Referrals can be made for treatment of large or multiple keloids that don’t respond well to the traditional treatment options.

Can keloid be prevented?

If you are in an at-risk group or have already had a keloid you should avoid body piercing and tattoos. You should also steer clear of unnecessary operations such as cosmetic surgery, especially in those areas of the body where keloid scars are prone to develop. If you have acne, you should make sure it is treated effectively at an early stage so the spots do not scar.

ROSACEA, ACNE, ACNE SCARS & Other Inflammatory Skin Conditions

Acne Keloidalis, Keloidalis nucahe , Cystic Acne, and Acne Vulgaris, Hidradenitis Suppurativa are inflammatory conditions that can result in unsightly scars of the face, scalp and torso, if left untreated. Permanent hair loss, as seen with Keloidalis nuchae, can also occur.

In some cases, steroid injections can help reduce inflammation and prevent scaring and or hair loss. Dermal Fillers can also be considered for treating ice pick scars caused by acne. Lasers like the (Lumenis M22) can also be used.

At Aesthetic Creations, we offer various non-surgical, minimally invasive treatment options for these inflammatory conditions to help reduce inflammation and improve the appearance of resulting scars.

Before and after pictures for Keloids

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