Keloids scars are raised, reddish-purple, nodular scars, which are firmer than hypertrophic scars. They will often continue to grow beyond the confines of the wounded area and do not regress over time. In some cases, they can produce large lumps several times larger than the original scar. Areas of the body such as the chest, neck and earlobes are more likely to develop keloids. Keloids are more common in African Americans, Asians, and Hispanics. Although they are generally harmless, people may choose to have them removed for cosmetic reasons. However, removing keloids through surgical excision is risky, because the resulting surgery scar may become a larger keloid.
Common symptoms of keloid scars include:
- Excessive overgrowth of scar tissue
- Reddish-purple in color
- Lumpy or ridged texture
- Continue to grow over time
Keloids occur as a result of skin trauma such as surgery, acne, piercings, cuts, burns, chickenpox or minor scratches.
Some scar tissue may become sensitive so it’s important to exercise proper skin care. Choose gentle cleansers for the skin, preferably in liquid form. These cleansers will gently remove dirt, excess oil, bacteria and cosmetics without irritating the skin. Avoid soaps, especially bar soaps, as they will often cause dry skin.When bathing, avoid scrubbing the skin too hard. This can also cause irritation to scar tissue. After washing, gently pat the skin dry with a towel. Moisturizers help to restore and maintain the skin’s natural moisture levels. Look for a moisturizer specially designed for sensitive skin that is free of fragrance, dye or other allergens that may irritate the skin.
Avoid trauma to the skin, including surgical scars. Aggressive treatment of acne and prevention of inflammatory blemishes in the skin may help prevent keloid scarring.Sun damage can be prevented to the skin and scar tissue by following these simple tips.
Limit sun exposure: Reducing your time in the sun is perhaps the easiest way to avoid damage to your skin caused by UV rays. When outdoors, set a time limit and seek shade when necessary. Also keep in mind that UV radiation is the strongest between the hours of 10 a.m. to 4 p.m.
Use Sunscreen: Sunscreens are an essential part of protection against the sun. Look for sunscreens that are labeled “Broad Spectrum”. They are often the most effective and offer protection against both UVA and UVB rays. Make sure to apply generously and frequently.
Cover and protect: Wrap-around sunglasses, wide-brimmed hats and clothing that covers your arms and legs, can offer extra protection against the sun’s harmful UV rays.
A doctor may administer Kenalog injections to treat hypertrophic scars. 5-FU injections are much less commonly used. The use of topical imiquimod applied after excision of the scars may be very useful. Corticosteroid injections may speed up and help the healing process.
Progress in laser technology and refinements in technique have made laser therapy a preferred treatment choice for keloid scars. Pulsed dye lasers (PDL) have shown to be very effective in treating scars with minimal side-effects and discomfort.Keloid scars can also be removed by shave excision. The scar is tangentially shaved with a flexible razor blade/scalpel until it is level with the surrounding skin avoiding entry into the deep dermis. However, there is a high risk of the keloid growing back larger than the original scar. Frequent cortisone injections after excision minimize the risk of recurrence.