KELOID

WHAT ARE KELOIDS?

Keloids are overgrowths of fibrous tissue or scars that can occur after an injury to the skin.In individuals prone to keloids, even minor traumas to the skin, such as ear piercing, can cause keloids. The word "keloid" itself comes from the Greek word for a crab's claw; it was first used by a French physician to describe the way that keloids grow sideways into normal skin.

When a wound heals, it leaves a scar. A keloid is a special type of scar; one that grows too much and can even become larger than the original wound. It is not uncommon for surgical or injury scars to become a little lumpy (hypertrophic scars). A keloid differs from these in several ways: 

Ø  A keloid can come up after very minor skin damage, such as an acne spot, or even if there has been no obvious damage to the skin at all.

Ø   It can spread outside the original area of skin damage.

Ø   It may last permanently

WHAT CAUSES KELOIDS TO OCCUR?

This is not fully understood; Most skin injury types can contribute to keloid scarring. This includes:

Ø  acne scars

Ø  burns

Ø  chickenpox scars

Ø  ear piercing

Ø  scratches

Ø  surgical cuts

Ø  vaccination sites

According to the National Center for Biotechnology Information, keloid scarring is common in people between the ages of 10 and 20, and also among African Americans, Asians, and Hispanics. Keloids tend to have a genetic component, which means you are more likely to have keloids if one or both of your parents has them. (NCBI)

Several things affect the risk of getting keloid: 

Ø  Being dark skinned; they are especially common in people with black skin.

Ø  Keloids can crop up anywhere but do so most easily on certain areas such as the skin around the upper chest and shoulders - particularly over the breastbone (sternum) - and on the earlobes.

Ø  Wounds that are under tension while healing, or which get infected, are· particularly likely to form keloids, as are burn and acne scars.

Ø  Having previously had a keloid increases the risk of getting another if subjected to trauma to their skin.

Ø  Keloids most commonly arise between the ages of 10 and 30 years

Keloids are not contagious and have a very small risk of turning into skin cancers, which is more likely if they are treated with radiotherapy.

ARE KELOIDS HEREDITARY?

No. However, 5-10% of Europeans with keloids have a positive family history.

WHAT ARE THE SYMPTOMS OF A KELOID?

Usually there are none; but some are tender, painful, itchy, or cause a burning sensation. The main problem is that their appearance may cause embarrassment. If they are very tight, they can limit movement at nearby joints.
WHAT DOES KELOIDS LOOK LIKE?

 Keloids look like exaggerated scars. They are raised above the skin around them and sometimes they are domed. They can extend beyond the limits of the skin damage that caused the scar to come up in the first place. They are shiny and hairless; usually they feel hard and rubbery; and new ones are often red or purple, becoming darker or sometimes paler as they age. Most people with keloids have only one or two. However some people have many, especially if they have come up after acne or chickenpox scars.

HOW WILL BE DIAGNOSED?

Your doctor will in most cases be able to make the diagnosis of a keloid just by looking at your skin. No investigations are usually needed.

CAN A KELOID BE CURED?

 It is unusual for a keloid to be cured after treatment. The main problem is that cutting a keloid out often leads to an even bigger one forming later in the same place.

HOW CAN A KELOID BE TREATED?

The decision to treat a keloid can be a tricky one—keloid scarring is the result of the body’s attempt to repair itself. Removing the keloid may mean that scar tissue only grows back again, sometimes larger than before. Examples of keloid treatments include:

Ø  corticosteroid injections(triamcinolone) to reduce inflammation

Ø  Steroid-impregnated tape applied for 12 to 24 hours a day may help to flatten keloids

Ø  moisturizing oils to keep the tissue soft

Ø  using pressure or silicone gel pads after injury

Ø  freezing(with liquid nitrogen) the tissue to kill skin cells

Ø  laser treatments to reduce scar tissue

Ø  radiation to shrink keloids

Ø  Sometimes, 5-fluorouracil and imiquimod are used to reduce size either· alone or before using other types of treatment

Ø  surgery to remove the keloid

These treatments can reduce or eliminate keloid scarring. However, keloids tend to shrink and become flatter over time even without treatment.

WHAT CAN I DO?

With keloids, prevention is better than cure. You have an extra risk of getting a keloid if: 

Ø  You have had a keloid before.

Ø   Members of your family have had them.

Ø   You have a dark skin.

If you are at risk, you should avoid trauma such as tattoos or body piercing, particularly if these would go through one of the high-risk areas of skin, such as the ear lobes. If you have acne, see your doctor to make sure it is treated vigorously to limit the risk of scarring. You should avoid having skin surgery for cosmetic purposes.

DR EMORINKEN KELVIN

emoshealthlounge.blogspot.com

APPRECIATION

British association of dermatologist

www.dermnetnz.org