A keloid scar or keloid is a type of scar resulting from an outgrowth of the dermis at a healed wound. It is in the form of firm lesions, rubbery or nodules which are shiny, fibrous and its color varies from pink to flesh or red to dark brown (for black skin). A keloid scar is benign, non- contagious and usually accompanied by severe itching and even pain sharp, its texture changes over time. In severe cases, it can affect movement of skin. In veterinary medicine, keloid proliferation of granulation tissue occurs during wound healing, preventing colonization of the area by epithelial cells and thus the closure of the wound. This is common in horses.
Keloid scar removal can be tricky.The healing process is characterized by a balance between synthesis and hydrolysis of collagen. During the proliferative phase, the rate of intake exceeds that of its collagen lysis. It is input and then lysed in balance during the maturation phase. At this stage, the structural collagen of the scar formed is reorganized by the joint action of the lysis and synthesis, resulting in a mature scar. In the case of keloids and hypertrophic scars, the equilibrium point, usually reached 3 to 4 weeks after the injury, is never reached. the contribution of collagen remains above its lysis for an indefinite period, causing a swelling in the scar. Hypertrophic scars growth continues indefinitely in both thickening and extending. Instead, a hypertrophic scar does not grow beyond the boundaries of the original injury. It stabilizes and then resolves spontaneously 2 to 3 years after injury. The stretching of the skin during or after healing, promotes the appearance of keloid. It appears due to skin lesions, such as a cut, a burn, a piercing or a surgical procedure. The tiny lesions caused by acne can cause keloids, giving the impression they appear spontaneously. Parts of the body are most affected, either because they are often more lesions (lobules of ears, lower face), or they are more prone to stretching of the skin (region of sternum, of the shoulders).
Keloid scar removal can be done by treatments. The effectiveness of the keloid scars treatment on mixed keloids and for hypertrophic scar removal explains the diversity of treatments used today. Keloid scar removal surgery used alone is not recommended because it often worsens the situation. Partial List of treatments includes Injections, Intralésionelles injection of corticosteroids delay, Infiltration of bleomycin, Infiltration of 5-FU (5-fluorouracil), Radiotherapy (with reoperation), By external radiotherapy, Brachytherapy intra-scar,Corticosteroids, Cryotherapy, Continuous compression, Ear Clips, Medical compression garment, Sports clothing used to compress, Sports underwear, Wrist band, Headband earmuff, Elbow, Knee, Silicone gel plates, Dermo-repairing gel for keloid scars, Cures, Care by Orthodermie, Laser, CO 2, Pulsed dye, Erbium, etc. Keloid scar removal requires large pre and post operative care. Some keloids tend to reappear after removal and can be larger than the original, and there are about 50% chance of recurrence after surgery. However, keloids are less likely to return if surgical removal is combined with other treatments. The keloid scar removal before and after differences are quite good. The laser or surgical hypertrophic acne scar removal may be followed by intralesional injections of corticosteroids to treat or prevent recurrence of the keloids. The suture of the skin plasty includes techniques such as the V and W as ways of reducing dermal tension, which reduces the incidence of recurrence of these lesions after extraction.
Dressings can be effective for keloid scarring too. Wet dressings executed in gel of silicone or sheets of silastic have been successfully tested as a means to reduce the prominence of keloids over time. This type of treatment is safe and painless, although some patients have experienced a sharp pain for an extended period. Injectable steroids are used primarily when the scar begins to thicken and when the patient has a history of keloid formation. Series inyeciones with triamcinolone acetonate or another corticosteroids may reduce keloid size, although injections can be quite uncomfortable. The bandages for compression are applied for several months on the keloid. This causes the reduction of the size of the lesion. They work best when used to prevent new lesions. Cryosurgery is an excellent treatment for keloids that occur in small, lightly pigmented skins. It is often combined with monthly injections of cortisone. The use of cryotherapy is limited because it causes skin depigmentation, which is frozen. It also runs the risk of reducing the blood circulation underneath. Its effect is a local burn freeze.
Radiation can be used for Keloid scar removal, but in very small quantities as to not affect internal organs. The ortovoltaica radiation is more penetrating and slightly more effective. No known evidence is there to establish that it may cause some form of cancer after many years of use, but its main drawback is that it is an expensive therapy. Radiation treatments can reduce scar formation if used after surgery, during the time the wound is healing. Therapy with laser is an alternative to conventional surgery for hypertrophic scar treatment. The laser can scale well with skin surface but does not reduce the whole mass of the keloid. Using dye laser has shown better results than the cold laser. New treatments are there too. The use of drugs to treat autoimmune diseases or cancers has shown promise. This includes interferon, 5-fluorouracil and bleomycin . Studies are needed and additional certifications should be done before recommending their widespread use in keloid scar treatment.
Keloid scar removal is not always wanted. The Olmecs used the scarification as a decorative medium of their bodies. In the modern era, women of Nubia, Sudan, also intentionally get facial keloids and use them decoratively. African ethnic Nuer and Nuba use lip implants, tattoos and keloids in the frontal region, chin and above the lip. As part of the ritual, the natives of Papua New Guinea make incisions in the skin, and then insert clay or ash so that they develop to permanent swellings. This ritual, though painful, makes the members respected for their tribal community, being honored for their courage and endurance.