Significance of Keloids

“Scars that don’t know when to stop” – these are words describing keloids. These are characteristically seen as itchy, hard or tough heaped-up scars ranging from pink to red in color that rise quite abruptly above the rest of the skin. These are also termed as keloid scars. These occur at the site of skin injury resulting from severe acne, a burn, an operation, a vaccination or just a minor scratch from an overproduction of scar tissue. These are irregularly shaped that tend to enlarge progressively and do not subside over time. They are harmless though.

The causes of the scar formation are yet unknown but researchers theoretically believe that these scars are from the body’s failure to turn off the healing process needed to repair the skin. It is why doctors are baffled why scars form in certain people or situations and not in others.

Keloids, however, have already been mentioned even as early as 1700 BC by Egyptian surgeons. It was identified as an entity in 1806 by Baron Jean-Louis Alibert wherein he called them cancroide but later changed it to cheloid to avoid confusion with cancer. The word came from the Greek chele (crab’s claw) and the suffix –oid (like). Other countries with differing customs used the scarring as decorative pieces on the body. Still others intentionally make the scar-like formations with the use of clay or ash inserted into the skin honouring members of their tribe who are celebrated for their courage and endurance.

Keloids are less common in children and the elderly but may occur often in people with darker skin types. Those with other skin types may likely develop them, too. The scars have the tendency to develop in families, so they are also said to be inherited. The scar formation can develop anywhere in the body. Common sites include the chest, the upper back, the shoulders, and even the earlobes. Rarely do they appear on the face except along the jaw line. To identify these, look for a flesh or lighter coloured nodule or ridged growths over the scars.

There is, however, no 100% effective treatment of the overlapping skin formation on scars following injury. There are companies these days who are working towards a more effective treatment focusing on Transforming Growth Factor Inhibition. Some treatments currently in use worldwide include the use of gels (Contractubex gel or Hexilak gel), steroid injections, cryosurgery, radiation therapy, laser therapy, compression bandages applied for several months on the scar, dressings made of silicone gel like Dermatix or silastic and lastly, surgery.

Of the aforementioned treatments, surgery alone is the least recommended for fear of a 50% chance of recurring keloid formation. Surgery done with other treatments is more likely to produce better results in preventing it from recurring. An Intralesional injection of corticosteroids after surgery or laser excision is one example. Another would be the application of plastic closure including techniques like v-plasty or w-plasty to reduce skin tension thereby reducing the recurrence of keloids following excision.