A keloid scar, which can also be known as just a ‘keloid’ or a ‘keloidal scar’, is a scar that is made from collagen. This gives it a firm, rubbery appearance, and they can grow quite large extending much larger than the original scar – unlike hypertrophic scars which are similar raised scars that stay within the outline of the original injury. They are created as a result of the granulation tissue in the skin over growing at the location of a healing scar. This is then slowly replaced by other forms of collagen – first type 1 and then type 2. In some cases it can be very itchy and painful, and it might also prevent the skin from moving normally. If the keloid gets infected it can ulcerate. They will not generally heal on their own and will generally continue to worsen if left making it important to get treatment for the scars as soon as they occur.
Treating Keloid Scars
It is unclear what causes keloid scars, but fortunately there are a number of ways to correct them, one approach is to use cortisone injections. These flatten the raised tissue, but they tend to still leave the skin looking different from the surrounding skin which is successful in around 70 percent of cases. It is also possible to remove the lesion with surgery (excision), though this can in some cases worsen then problem and particularly if it causes more scars to form. A doctor might also recommend applying silicone sheets to the scars, called ‘silicone gel sheeting’.
This treats the symptoms of pain and itching, but is more a method of management than a cure as such. It is also possible to use radiation therapy which has been found to be highly effective in treating keloids in many studies. However there are some concerns related to the risks surrounding radiation on what is essentially a benign disorder so it is limited mostly for extreme cases. Pulsed dye laser treatment is used to regress keloids and is often used in combination with corticosteroids and other methods. Cryosurgery involves freezing the lesion to remove it and is also best used alongside other treatments. Finally interferon alfa injections can be used in the area to reduce the recurrence of keloids.