The human body is an amazing structure of complexity. It knows well how to react in normal situations, and in situations that require urgent attention. If we get hurt and bleed, the body immediately senses it and starts the process of wound healing. Usually, the cells that are lost during hurt or injury are replaced by new cells. Sometimes we might have observed that there is extra tissue that has grown over a healed wound. This extra growth of scar tissue over a healed wound or injury is called keloids. Keloids are usually harmless, and the treatment is sought mostly for cosmetic reasons.
About Keloids
Keloids are hard, firm, irregular-shaped overgrowth. It may be painful or asymptomatic, uncomfortable and itchy and is usually larger than the original injury. They are formed either immediately after injury or several months later. Keloids do not develop after every injury, but some develop even after minor injury, insect bite or even by small pimple. Keloids may develop on any part of the body, but they especially form in the upper chest, upper back, and shoulder region. Keloids are more common in dark-skinned people than in whites. Keloids are non-cancerous growth.
Causes
The exact cause of keloids is not known, as many people do not develop it after a major injury, while others develop it even after a small cut or insect bite. Keloids occur in people who are predisposed to it. It occurs after skin injuries such as burns, traumatic wound, surgical cut, cut with a knife, insect bite, acne (pimples), ear piercing, tattooing, minor scratch, chicken pox, vaccination sites and infections like furuncle (like boils), abscess (localized collection of pus), and cystic acne.
People at risk
Keloids are very common in African-Americans, in young women who are below 30 years, in pregnant women, in teenagers going through puberty, and if there is a history of keloids in the family. Keloids are hereditary and run in families.
Symptoms
Keloids usually appear like a skin lesion that is red, pink or flesh-coloured. It forms over the site of injury that has healed. Keloids may be tender to touch or maybe lumpy and rigid. The person may complain of itching when the keloid is forming or growing.
Diagnosis
Diagnosis is done based on the appearance of the scar, but very rarely skin biopsy is taken to rule out other skin conditions and tumours.
Treatment
Keloids are usually harmless, and in most cases, they do not need any treatment. But few people in whom keloids develop in areas that spoil their appearance can approach a doctor, who can reduce the size of the keloids by
- Applying external pressure or pressure dressing
- Applying moisturizing oils
- Giving corticosteroid injections for a few weeks
- Freezing (cryotherapy) or cryosurgery with liquid nitrogen is shown to produce very good results by flattening the keloids
- Silicone gels or wearing silicone sheets over the scar
- Laser treatment
- Radiation
- Surgical removal
Different treatment suits different people, which will be decided by the doctor.
Prevention
Keloids can be prevented by applying a cream called Imiquimod. The cream is prescribed after surgery to prevent keloid formation or to prevent keloid from returning after keloid removal surgery. People at risk for developing keloids should avoid piercing or tattooing their bodies. In case of ear piercing the person can wear a pressure earring to prevent keloid formation. Right after surgery, pressure dressing and corticosteroid shots may help flatten the scar. Avoid scratching acne lesions, insect bites or any other skin irritations. If a keloid is forming, then the discolouration of the keloid can be prevented by wrapping it with a bandage or by applying sunblockers at least 6 months after surgery or injury.
Outlook
Keloids are not medically dangerous but they are a concern, if they appear in regions that disturb the appearance of a person. In some keloids may become flattened and less noticeable after a few years but in many, they usually do not go. Avoid exposing the surgical or injured areas to sunlight as they might turn the keloids into a permanent dark colour. Consult a doctor about surgical removal of keloids but think twice as sometimes surgical removal may result in even bigger keloids. Discussing all these with a doctor before undergoing surgery is very important to avoid keloid formation.
