Introduction

Keloid scars are defined as abnormal scar tissue that grows beyond the boundary of the original site of a skin injury. It is  a raised and irregular growth of skin in the area of damaged skin.

Although anyone can form a keloid scar, some ethnic groups are at much more risk of developing these skin lesions. Some areas of the body seem more prone, the upper arm, upper back, and the sternum. The earlobes and the back of the neck are also common sites. You are 16% more susceptible if you are African-American or Hispanic. Keloid scars are seen 15 times more in highly pigmented ethnic groups rather than Caucasians.

It isn’t fully understood why keloid scars occur. Skin trauma appears to be the most common factor. Skin and/or muscle tension seem to contribute to increased keloid formation in many areas, but this is not always the case. Infection at a wound site, repeated trauma to the same area, skin tension or a foreign body in a wound can also be important factors.

There appears to be a genetic component to keloid scarring. If someone in your family has keloids then you are at increased risk. Other theories for the causes of keloid scarring include a deficiency or an excess in melanocyte hormone (MSH), decreased percentages of mature collagen and increased soluble collagen, or that very small blood vessels get blocked and the resulting lack of oxygen contribute to keloid formation.

Keloid scar prevention - the fact is that there may be very little a person can do if they are unfortunate enough to have the sort of skin that reacts by forming keloid scarring. They can assist the healing process by keeping any wounds clean to reduce the chances of infection. If a person knows they are susceptible because of previous experience or a family connection then they can avoid taking extra risks. The susceptible individuals should not have piercing or tattoos and make sure they tell their doctor if they are going to have surgery. There is a high rate of recurrence of over 50% with keloid scarring. Highly pigmented people should avoid tattoos, tattoo removal laser, skin lasers and body piercing.

The best treatment is prevention in patients with a known predisposition. This includes preventing unnecessary trauma or surgery (including ear piercing, elective mole removal), whenever possible. Any skin problems in predisposed individuals (e.g., acne, infections) should be treated as early as possible to minimize areas of inflammation.

Intralesional cortisone injections are first-line therapy for most keloids. A systematic review found that up to 70% of patients respond to the keloid injections. Following injection treatments, Fraxel laser keloid scar removal can improve the keloid scar remnants in most patients. Scar removal surgery is not recommended because it may create similar or worse scars than the one being treated. MD Cosmedical Solutions Sydney can offer you the best advice to reduce your keloid scars.

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