Scar formation is the body’s natural response to injury. Fibrous tissue, called scar tissue, forms over the wound to repair and protect the injury as it heals. How your skin scars depends on several factors including the size, depth, and location of the wound as well as your age, gender, and heredity. About ten percent of people have a tendency to grow extra scar tissue that forms smooth, hard growths that extend beyond the edges of the original wounds. These keloid scars are seldom harmful but may be itchy, tender, and unsightly and are particularly troublesome when highly visible.
Keloids are the result of an over-aggressive healing process. They are sometimes referred to as ‘scarring that didn’t know when to stop’ and have traditionally had a tendency to recur when treated. Newer treatment methods and combinations of therapies have proved effective and provided our patients with long-lasting relief.
Jennifer Wong, PA-C with Advanced Dermatology, P.C.
Keloid scars can be caused by many types of skin injuries from surgical incisions to burns to cosmetic piercing. They develop most often on the chest, back, shoulders, and earlobes. They are equally likely to afflict both men and women but are less common among children and the elderly. Although people with darker skin are more prone to develop keloids, they can occur in people of all skin types.
“There is thought that there might be a genetic component to the tendency to develop keloids,” says Wong, “so those with a family history are advised to think twice about ear piercing and other procedures. While it is impossible to predict with certainty who will develop a keloid, anyone who has developed one in the past should avoid elective surgery and any cosmetic body piercing.”
The decision to treat a keloid depends on its location and on how troublesome it is, visually or due to itchiness or irritation. Larger keloids are more difficult to treat and more likely to recur, sometimes bigger than before. Depending on the size and characteristics of the keloid, less invasive treatments may be recommended, particularly for a newly formed keloid. These might include silicone pads or pressure dressings that have to be applied carefully and frequently over a period of weeks or months. More than one type of treatment is often needed to achieve satisfactory reduction or elimination of a keloid. These treatment options include:
- Corticosteroid injections given several weeks apart generally help shrink the keloid after a series of treatments. Because these injections may increase redness, laser treatment may also be used to reduce redness. And since many keloids regrow – sometimes years later – a second therapeutic option is often included in the treatment plan.
- Cryotherapy, which reduces the keloid’s size and hardness by freezing it, is often used in conjunction with corticosteroid injections.
- Surgical removal seldom achieves permanent removal as might be expected and to prevent recurrence, surgery is often followed with radiation or corticosteroid injections.
- Radiation can be effective in treating keloids but in some cases poses danger to other organs. A recent option known as ‘superficial radiation’ targets the cells that cause the excess scar tissue and is safer as a post-surgical therapy. Several daily treatments are administered within a day or two of surgery to prevent the production of abnormal collagen.
- Pressure dressings, silicone sheets and gels are also used after surgery to prevent regrowth. A pressure earring is often used after a keloid is removed from an earlobe.
By carefully assessing each patient’s needs and combining therapies, we can reduce the size and symptoms of a keloid, often remove them entirely and reduce the risk of recurrence. It’s important that each patient consider their primary objective in treating a keloid and work with their doctor to develop the treatment plan that is best for them.
About Jennifer Wong
Jennifer Wong, RPA-C is a certified registered physician’s assistant specializing in dermatology with Advanced Dermatology PC.
Advanced Dermatology P.C.and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies. Come into the beautiful world of Advanced Dermatology PC.