Keloid scar, how to treat it? – MAPFRE Blogs

Keloid scars are a type of raised and thickened scar. Know its causes, symptoms and treatments to reduce its aesthetic impact.

Dermatologists often see patients who complain of scars that not only persist, but grow outside the area of ​​the original injury. These are keloid scars, a type of scar that alters the quality of life due to aesthetic issues or physical discomfort.

What is a keloid?

A keloid scar is a thickened scar that is formed by an exaggerated response of the body in the process of wound healing. Unlike normal scars, which stay within the confines of the original wound, keloids invade neighboring areas and can continue to grow for months or years.

They must be distinguished from hypertrophic scarswhich are also elevated but remain within the limit of the wound and improve over time. Keloids, on the other hand, tend to be recurrent and are more resistant to treatment.

Main causes

The cause is not known with certainty, but there is an overproduction and disorganization of collagen in the healing process. Among the most important factors are:

Genetic predisposition

Individuals with a family history of keloids are at increased risk. They are more common in people with darker skin, but can occur in any phototype.

skin lesions

Any injury to the skin can cause a keloid:

• Courteous
• Burns
• Surgeries
• inflammatory acne
• Piercings or piercings
• Injections or vaccines
• Scratches and bites.

Age

They are most common between the ages of 10 and 30, when collagen is produced the most.

anatomical location

There are certain areas of the body that are more vulnerable:

• Upper chest
• Shoulders
• ear lobes
• Jaw.
• High back

How to identify a keloid?

Keloids are recognized both by their appearance and by the symptoms they cause. Among the most common are:

• Hard, raised lump with irregular edges.
• Growth that goes beyond the limits of the initial injury.
• Red, purplish or darker than the surrounding skin.
• Constant itching
• Tightness.
• In some cases, pain or tenderness.

Over time they can harden and change color, but they hardly disappear without treatment. With MAPFRE Health Insurance, you can access specialized dermatological treatments to treat keloid scars and improve your aesthetic well-being.

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Normal stages of healing and what is altered in a keloid

Normal healing goes through three phases:

• Inflammatory phase (0-5 days): the body initiates its defense mechanisms.
• Proliferative phase (5-21 days): New collagen and granulation tissue is formed.
• Maturation phase (21 days to months): Collagen is reorganized and the scar is flattened.

In keloid scars, the imbalance occurs in the proliferative and maturation phases. The body continues to generate excess collagen, uncontrollably, and the tissue grows larger than necessary, extending beyond the edges of the original wound. This can take years.

Available treatments

There is no single treatment that works for everyone, but there are many things that can be done to improve appearance, relieve symptoms or slow progression. In many cases, the best way to do things is by mixing several techniques.

Intralesional corticosteroids

They are one of the first line treatments. They are injections into the keloid that reduce inflammation, itching and size. They are usually put every 3-6 weeks.

Laser

The vascular or fractional laser reduces redness, smoothes the texture and improves the overall appearance. It is usually associated with corticosteroids or silicone.

Cryotherapy

Liquid nitrogen freezes the tissue, gradually flattening it. It is more effective in small keloidsalthough it can cause pigmentation alterations, especially in dark skin.

Silicone sheets or gels

They are applied consistently to moisturize, soften and control the growth of scar tissue. They are more effective in initial stages or as a complement to other treatments.

Pressotherapy

Especially indicated for keloids on earlobes after piercings. Pressure devices prevent recurrence after surgery.

Surgery

Surgical resection can be curative, but has a high risk of recurrence if used as the only treatment modality. That is why it is usually associated with corticosteroids, silicone or superficial radiotherapy.

Superficial radiotherapy

It is applied after surgery to reduce the possibility of the keloid recurring. It should be used with control and in very precise cases.

How to avoid keloids?

Susceptible people should take preventive measures:

• Avoid unnecessary piercings, tattoos or surgeries.
• Manage acne early to prevent deep inflammatory scars.
• Treat any recent wound properly, avoiding excessive tension or stretching in the area.
• Use silicone sheets after surgeries, especially in risk areas.
• Cover recent sun scars to prevent darkening and worsening of their appearance.
• See a dermatologist as soon as possible if a scar begins to grow larger than normal.

What you should know…

• Keloids are abnormal scars that grow beyond the original wound, caused by an exaggerated response of the body with excessive and disorganized production of collagen.
• Its formation depends on multiple factors, such as genetic predisposition, type of skin lesion, age and anatomical location. It is most common in the chest, shoulders, ears and jaw, and can cause itching, pain, tightness and color changes.
• The treatment is varied and usually combines several techniques, such as intralesional corticosteroids, laser, cryotherapy, silicone, pressotherapy, surgery with adjuvants or radiotherapy.

Literature

• Betarbet U, Blalock TW. Keloids: A Review of Etiology, Prevention, and Treatment. J Clin Aesthet Dermatol. 2020 Feb;13(2):33-43. Epub 2020 Feb 1. PMID: 32308783; PMCID: PMC7158916.