Keloids and hypertrophic scars are a natural response by your body to an injury caused by an accident or medical procedure. While they do not cause disfigurement, they can become visually unpleasant, painful, and distressing. This article will explain what keloids and hypertrophic scars are, the treatments available and how to treat keloids at home.
What are keloids and hypertrophic scars?
Keloids and hypertrophic scars are both abnormal healing responses to injury. They are more common in darker-skinned individuals, particularly those of African descent because their skin is more prone to hyperpigmentation. Keloids and hypertrophic scars can appear anywhere on the body, but they most often develop on areas that have been traumatized by acne or surgery.
What are keloids?
A keloid is a growth of excess scar tissue at the site of an injury. The scar extends beyond the borders of the original wound and can be itchy, painful, and unsightly. Keloids are often described as feeling like sandpaper or chicken skin. They occur most frequently on the chest, shoulders, and back but may also appear on arms, legs, or neck. Keloids may be dark brown or black in color because they contain excess amounts of melanin (skin pigment).
What are hypertrophic scars?
Hypertrophic scars form when the skin’s natural healing process goes awry due to the overproduction of collagen (protein). When this happens, the scar grows beyond its normal boundaries and becomes raised above surrounding tissue. Hypertrophic scars usually appear pinkish in color because they lack pigment (color).
If you have a scar that is healing, you can help to prevent it by following these guidelines:
- Avoid picking or squeezing the scar. This may cause the skin to become redder, swell, and increase the risk of developing a keloid.
- Apply silicone gel sheets or silicone gel cream to the scar twice daily for 12 months or longer after your injury. This will help flatten raised areas on the skin and reduce their appearance.
- Keep the area moisturized. Use petroleum jelly or an oil-free moisturizer with SPF 15, which is available over-the-counter (OTC). Avoid using oils such as olive oil until your doctor says it’s okay.
- Avoid exposure to sunlight, tanning beds, and sun lamps while using silicone gel products on your scar — they may increase your skin’s sensitivity to light and could cause irritation around the scar area.
How to manage keloids and hypertrophic scars
The good news is there are treatments available for keloid and hypertrophic scarring that can help prevent future recurrences of these unsightly conditions. These treatments include:
One treatment option is surgically removing keloids with a technique called excision surgery (also known as surgical curettage). In this procedure, your doctor will cut away a portion of the affected skin along with any underlying scar tissue or other tissue causing irritation or discomfort. The goal is to make sure the surgery cuts away all unwanted tissue while leaving healthy tissue intact so it can heal properly without forming additional scars, you can learn more about surgery when you click here.
Corticosteroid injections are used to reduce the inflammation associated with these conditions, which helps them heal more quickly. Corticosteroids can also help prevent scars from becoming larger or more raised over time. Corticosteroid injections are usually performed by your dermatologist or plastic surgeon, who will administer the treatment using local anesthesia.
You’ll likely need several corticosteroid injections over time to treat your keloids or hypertrophic scars, depending on how severe they are. Your doctor should give you instructions on how often to come in for treatment based on the severity of your condition and how much improvement has been seen so far with previous treatments.
Fasciocutaneous Flap Closure
This is the most commonly used technique in the management of keloids and hypertrophic scars. It involves raising a skin flap over the affected area and then stitching it in place. This method is easy to perform and can be done under local anesthesia if needed. The main advantage of this technique is that it gives good cosmetic results with minimal scarring.
Imiquimod Cream Application
Imiquimod cream is a topical treatment for warts, molluscum contagiosum, actinic keratosis, and genital warts that has also been shown to be effective at treating hypertrophic scars and keloids when applied twice daily for up to 16 weeks.
Skin grafts are often used to remove large or recurrent scars. The donor tissue is taken from another part of your body and transplanted onto the scarred area. The graft will eventually merge with your skin and grow into it. Skin grafts require multiple surgeries and may leave a permanent depression in the skin where the donor tissue was removed.
Radiation therapy is a type of treatment that uses high-energy x-rays to destroy cancer cells. Radiation therapy uses x-rays to kill cancer cells, shrink tumors and help prevent them from growing back. If you have keloids or hypertrophic scars and want to know if you should consider radiation therapy as a treatment option, talk with your doctor. Radiation can be used to treat keloids and hypertrophic scars in two ways:
External beam radiation therapy (EBRT) — This type of radiation therapy uses special equipment outside the body to deliver concentrated beams of radiation. The beams are aimed at the tumor from different angles to give it maximum exposure with minimal damage to healthy tissue. This technique is often referred to as teletherapy.
Internal radiation therapy — Internal radiation therapy involves giving the patient radioactive material that is placed directly into or near the tumor site.
Laser Resurfacing (Ablative)
Laser resurfacing uses a laser to remove the top layer of skin. It can be used on keloids and hypertrophic scars. The procedure is usually done in the doctor’s office, but it can also be done in a hospital under general anesthesia. The procedure takes about 30 minutes.
Before laser resurfacing, the area will be cleaned with an antiseptic solution. A cool liquid may be applied to numb the area before treatment begins. The doctor will make small cuts in the skin, then apply a numbing cream and cover it with a bandage for several hours following treatment. Some people have side effects after this procedure, including redness, swelling, pain, crusting or scabbing of skin, infection, and scarring at the site of treatment.
Keloids and hypertrophic scars are very common and treatable problems. Keloids are overgrown tissue that are often itchy, painful, and may even reoccur after surgery. However, there is a bright side if you have keloids or hypertrophic scars, depending upon how they are treated.