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Scarred no more

Treating and keeping keloids away

Time may heal all wounds, but not all scars fade in time. In fact, some even worsen through the years, like keloids. Keloids are shiny, hairless mounds of excess skin that sometimes form after a wound. This irregularity in appearance makes a keloid unpleasant to look at especially when it appears in visible places of the body, like the face, neck, or arms. And because most of us place importance on having smooth, youthful, and flawless skin, having keloids can be uncomfortable and embarrassing, such that it may affect one’s self-esteem. This week, let us learn the effective treatments for keloids, and how they can be avoided.

Keloids come from the Greek word cheloid, or crab claws, because of their mounted appearance on the skin. Keloids are raised scars that formed abnormally while in the wound-healing process. The overproduction of scar tissue makes the keloid grow beyond the wound’s borders, making it look thick, raised, and tender. There are vessels feeding on the keloid that is why it tends to grow more instead of regressing like any other scars. Keloids do not have symptoms, but at times they become itchy, painful to the touch, or have a burning feeling, but they must not be confused with hypertrophic scars. While they are both irregular responses to skin trauma and initially look similar -tender, slightly raised, and pink or reddish at the onset, keloids do not fade in time as hypertrophic scars do; in fact, keloids can even grow beyond the wound’s border as time passes. Moreover, keloids are common among dark-skinned people, and as some studies mention, in Asian and Latin American races, and usually appear on shoulders, neck, back, upper arms, earlobes, and the face, but hypertrophic scars can appear on anyone, on any part of the body, at any age, and regardless of skin color or race. While keloids are not hereditary, some studies claim there is a higher occurrence among individuals where family members have them. Sometimes, even when there is no family history, keloids may appear due to different skin traumas like surgery, burns or body piercings, vaccines, certain illnesses that include skin lesions like chicken pox, and at times due to hormonal changes like puberty or pregnancy.

Diagnosing a skin lesion as a keloid is easy; it can be determined as fast as a simple visual check by the dermatologist. But treatment is a challenge. Although keloids are considered benign tumors, they rarely or almost do not become a cause for concern. Often, individuals with keloids leave them alone, except for those with large or exposed keloids who opt to have it removed. This is the tricky part, because when keloids are cut open, they tend to form again where the cut was made. This is why multiple treatments or a combination of it are required by the dermatologist to keep the keloid from recurring. Common options to treat keloids are through corticosteroid injections to reduce swelling, silicone gel pads left for 12 hours or more to even it out, and cryotherapy (using very cold temperature to stop growth). Lasers are best used to degrade the fibrosis and to collapse the blood vessels feeding the keloid scars.  One will see significant reduction of scars after eight to 10 laser sessions in combination with the intralesional steroids injection. Home and natural remedies, such as vitamin E, are rarely and not as effective as the treatments described above.

Because treating keloids are tricky, it is better to avoid having them than run the risk having them permanently. If you think you have a higher chance than others to have keloids (hormonal changes, family member has it, dark skin, etc.), it is best to avoid any skin procedure that requires some time to heal, such as tattoos and piercings, especially in keloid-prone areas. If you already have a keloid and you notice that it keeps on growing, consult a dermatologist right away. Also, do not try to remove keloids on your own, as they will only worsen with their recurrence. A keloid is usually nothing to be scared about health-wise, but if its appearance becomes a nuisance and affects your overall appearance and well-being, then it is always better to have it removed.