Keloid Scars

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    Many people find keloid scars annoying because they can be unattractive or gross. Sometimes, keloids are inevitable due to their genetic factor, and removing the scars require complex procedures.

    If you find yourself struggling with healing keloid scars, you can learn how to deal with and remove them in this article. Let us guide you through the tips on how to remove them and how you can prevent keloid scars from appearing on your skin!

    What are keloids?

    Keloid refers to the raised skin tissues that develop after minor injuries such as piercing, scathes, and acne breakouts. However, not all of these injuries will lead to keloid scars formation.

    Keloids only form when the skin produces excessive fibrous tissue to protect the wounds. Excess fibrous tissues typically bulge and appear in a variety of colours, ranging from pink to skin-coloured to darker than the actual skin tone.

    If you experience keloid scarring, you don’t need to worry about it, as these scars are harmless to your health. However, if you feel disturbed with the appearance of your keloid scars, you might need to remove them by trying several treatments.

    What causes keloid scars to occur?

    Keloid scars commonly occur after the skin heals from minor injuries. Typically, the fibrous tissue will naturally develop over the wounds to protect and repair the broken tissues. In some cases, instead of completely patching the skin up, the fibrous tissues are overgrown and forming raised scars or keloids. 

    According to Healthline, these types of injuries can lead to keloid formation:

    • Burns scars
    • Piercing scars
    • Surgical scars
    • Scratches scars
    • Severe acne scars
    • Chickenpox scars
    • Vaccination scars

    However, this type of scarring will not affect everyone. Genetics plays a significant role in determining whether or not people will develop keloids. According to Henry Ford Health System research, only people who have the AHNAK gene have a high risk of developing keloids.

    If you’re one of those people who have keloids and dislike their bulging appearance on your skin, you can opt for keloid removal treatments or do steps to avoid the fibrous tissue from overgrowing.

    What are the symptoms of keloid scars?

    Keloid scars do not usually happen without any preceding signs. According to the American Academy of Dermatology Association, there are some symptoms you might want to look for so you can treat your keloids properly:

    • Pink, red, or purple-coloured scars: Keloids mainly start with pink, red, or purple-coloured blotches. It’s common for keloids to begin as small and bulged spots contrasted with the surrounding skin.
    • Slow and enlarged scars: Keloids usually start as a small lump and slowly grow and disperse within 3 – 12 months after the skin injury. 
    • Pale and bouncy scars: If you touch keloid scars, they will feel different than the surrounding skin areas. Keloids are primarily pale and have a springy texture.
    • Itchy and sore scars: The common symptoms of newly developing keloids are itchy and painful sensations within the wounds. Avoid scratching your scars to prevent further damage.

    Keloid vs hypertrophic scars

    Even though keloid and hypertrophic scars have raised appearance, there is still a difference between the two. Keloid scars can be identified by their bouncy textures, whereas hypertrophic scars are thickened scars that follow the injury lines.

    Dense fibrous tissues cause both keloid and hypertrophic scars, but only people who have keloids in their genes develop these scars. Though for hypertrophic scars, people prone to this usually get it from various factors and not simply just from genetics.

    Causes

    Various factors such as burn scars, piercing scars, severe acne scars, and many more can trigger keloid formation. However, not everyone who experiences similar scarring issues will develop keloids on their skin. 

    On the other hand, physical trauma that leads to excessive collagen production mainly causes hypertrophic scars. Anyone can experience hypertrophic scars if exposed to skin injury and have that trait.

    Areas of emergence

    It’s unusual for keloids to occur in random areas of infection. This type of scar typically appears in a few places, including the shoulder, upper arm, behind the ears, and cheeks. 

    Hypertrophic scars can appear on every skin area depending on the damage occurrence. 

    Growth

    A hypertrophic scar is the type of blemish that can diminish independently. In most cases, hypertrophic scars fade within a few months to years. 

    Since keloids are almost impossible to remove without clinical treatment, it’s best to get it treated immediately to avoid the keloid scar from growing compared to the previous size.

    Fortunately, you can prevent this by consulting and setting up an appointment with a medical aesthetics doctor. They can help by recommending and providing suitable medical treatments for you.

    Size comparison

    Keloids are bulging scars that mostly grow more than 4 millimetres on the skin’s surface. In comparison, hypertrophic scars commonly are 4 millimetres or smaller.

    Home remedies for keloid

    If you are still hesitant to permanently remove keloid scars clinically, you can still opt for home remedies. However, you need to understand that home treatment can only reduce keloid scars and does not entirely remove them.

    Home remedies will not give instant and optimal results in many cases, especially if the keloids are severe and challenging to repair.

    Fortunately, applying over-the-counter (OTC) ingredients can effectively disguise some minor keloid scars. Here is the list of OTC ingredients that you can try:

    • Vitamin C: Vitamin C is an ingredient that promotes collagen production in your skin. It also has a brightening agent that helps reduce dark scars.
    • Centella Asiatica: Centella Asiatica contains active compounds that help with promoting collagen productions. It’s a traditional medicinal plant that is proven to treat wounds effectively.
    • Vitamin E: Applying vitamin E oil onto your keloid scars is beneficial to protect the wounds by keeping them moist.
    • Silicone gel: OTC topical silicone gel can help in reducing the scar’s texture, colour, and volume. With its self-drying technology, silicone gel can effectively decrease itching and any discomforts associated with the wounds.
    • Onion extract: Onion extract ingredients commonly found in OTC topical scar treatment creams. The active agents effectively prevent fibrous tissue from growing on the skin.

    Treatments to reduce keloid scars appearance

    To permanently remove keloid scars, you might need to undergo clinical treatments. You can book a consultation with a medical aesthetics doctor within your area to plan the further keloid removal procedure.

    According to Web MD, keloid scars primarily respond best with these kinds of clinical cosmetic procedures: 

    Steroid injections

    Steroid injections involve a doctor who injects corticosteroids to the keloid scars. According to the American Academy of Dermatology Association, the wounds will shrink gradually after patients receive four shots within a 3 – 4 weeks interval. 

    Typically, 50% – 60% of patients who receive corticosteroids may reduce the bulging appearance of keloids. However, these scars may reoccur within five years. Thus many medical experts may combine steroid injections with other treatments.

    Keloid-cutting surgery

    The keloid-cutting surgery involves a medical specialist who cuts the excess fibrous tissue of keloid scars. Due to the possibility of keloid recurrence, many medical specialists will combine this surgery with laser treatments.

    Laser treatments

    Frequently, laser treatments are used in combination with steroid injections or keloid-cutting surgeries. Patients who receive laser treatment may see their keloids flatten and their scar hyperpigmentation fade.

    If you wish to improve your keloid scarring with laser treatment, you might want to choose Agnes RF and Fractional CO2 laser treatments. Both types of lasers employ advanced techniques proven to reduce the dark appearance of keloids and even them out with the surrounding skin tone.

    Agnes RF

    Agnes RF is a minimally invasive radiofrequency-based laser treatment that may improve several skin conditions, including hyperpigmented keloid scarring. This technique works by delivering heat from the radiofrequency into deep skin layers. Ultimately, the skin will stimulate cell renewal and break down the excessive melanin.

    Furthermore, patients who previously underwent surgical keloid removal treatments can also opt for Agnes RF to maximise the final results.

    Fractional CO2 Laser

    Fractional CO2 Laser is another non-surgical treatment that may enhance the appearance of various skin problems, including keloid scars. This method works by delivering fractional photo thermolysis that infiltrates into skin layers, promoting collagen renewal and reducing uneven skin tone.

    Similar to Agnes RF, Fractional CO2 Laser can also complement other treatments such as steroid injections and topical medications. Patients who combine this technique with other therapies may achieve more optimal results.

    Cryotherapy

    Cryotherapy involves a medical expert using a specialised machine to freeze out keloids. Ultimately, as the machine freezes out the keloids scarring, patients may be able to prevent their scars from growing.

    Interferon injections

    Typically, a specialised doctor will perform interferon injections, or a protein naturally produced by the human body, to the keloid scarring. Although interferon is primarily used to treat cancer and chronic virus infections, it is also effective in reducing the size of keloid scars.

    Fluorouracil and bleomycin injections

    Fluorouracil and bleomycin are primarily anti-cancer substances. However, when injected into the scarring, these two agents may effectively treat keloid scars.

    Radiation therapy

    A specialised doctor performs radiation therapy, who delivers thermal radiation into the patient’s skin. According to the American Academy of Dermatology Association, it is common for specialist doctors to perform this therapy within a few days to a week after patients undergo keloid-cutting surgery.

    Pressure earrings

    People who have keloids within their ear can fix their issues by using pressure earrings. In most cases, keloids are caused by infection due to an allergic reaction to the piercing. When a keloid appears, the doctor can use pressure earrings to suppress it and shrink it while also preventing it from expanding or thickening.

    Preventing keloids

    Although keloids mainly stem from genetic factors, you can still prevent the scars from occurring on your skin. You can stop the fibrous tissues from enlarging by paying attention to the signs.

    Here is the list of keloids prevention strategies, according to the American Academy of Dermatology Association:

    • Use pressure earrings: For some people, keloids can appear after ear-piercing procedures. If you notice thickening on your earlobe, you need to act quickly using pressure earrings.
    • Test spot before a tattoo, piercing, or surgery procedure: It’s advisable for you to conduct a test spot before doing the tattoo, piercing, or surgical procedure. If you notice the thickening in the small areas, you can avoid the process so you can prevent keloid scarring.
    • Tell your surgeon that you are prone to having keloids: While tattoo and piercing are unnecessary, sometimes you need surgery. It’s best to inform your surgeon that your skin is sensitive and prone to growing keloids.
    • Take care of your open wounds: It’s almost impossible to prevent yourself from an unexpected accident that leads to open wounds. To avoid the wounds into keloids scarring, you need to keep the wounds clean and moist by applying silicone gel. You can also protect the wounds from direct sun exposure by using SPF.

    Summary

    Let’s review what we know about keloid scars! First, we see that it’s commonly stemming from genetics. It requires people with a family history of keloid scars to take extra precautions to prevent these raised and bouncy scars from appearing.

    There are home remedies you can try to reduce the blemish texture and discolouration if you are prone to have keloids. Home remedies are not adequate to give permanent results, though, so you might need to go to a medical aesthetics doctor for permanent removal, depending on severity.

    Consult with Dr Dylan Chau, our medical aesthetics doctor, to plan out the proper treatments for keloid removal.

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