Keloids are a type of raised scar that develops after skin injury, appearing as firm, rubbery lesions ranging from pink to flesh-toned. They are characterized by an overgrowth of dense, fibrous tissue that extends beyond the original wound boundaries. While keloids can form anywhere, they are common on the nose, often stemming from piercings, acne, surgical incisions, or other trauma.
Understanding Nose Keloids
Keloids are an abnormal healing response where the body produces excessive collagen during repair. Unlike typical scars confined to the injured area, keloids expand beyond the original wound margins, contributing to their raised, irregular appearance.
Common causes of keloids on the nose include piercings, severe acne, and surgical procedures like rhinoplasty or mole removal. Even minor injuries or skin inflammation can result in these prominent scars, especially for those with a genetic predisposition or darker skin tones. Keloids on the nose can be noticeable and cause discomfort, itching, or pain, impacting both appearance and quality of life.
Professional Medical Treatments
Addressing keloids, especially on the nose, typically involves professional medical interventions due to their stubborn nature and tendency to recur. Various approaches are available, often used in combination for better outcomes.
Surgical removal
Surgical removal involves excising the keloid tissue. However, surgery alone carries a high recurrence rate because cutting the skin can stimulate further keloid growth. Therefore, surgical excision is frequently combined with other treatments to reduce recurrence.
Corticosteroid injections
Corticosteroid injections are a common first-line treatment for keloids, especially for smaller lesions. These injections, often using triamcinolone, reduce inflammation, inhibit collagen production, and break down collagen fibers, helping to flatten and soften the scar. Injections are usually administered directly into the keloid monthly for several months.
Cryotherapy
Cryotherapy involves freezing keloid tissue, usually with liquid nitrogen, to destroy excess scar cells. This process induces cell death, reducing keloid size and volume, and alleviating symptoms like itching and pain. Cryotherapy is effective for newer or smaller keloids and can be combined with other treatments, such as corticosteroid injections, for enhanced results.
Laser treatment
Laser treatment uses concentrated light to target blood vessels, reduce keloid redness and size, or vaporize scar tissue. Different types of lasers are used depending on the keloid’s characteristics. Laser therapy can improve keloid texture and appearance, often as part of a multi-modal treatment plan.
Radiation therapy
Radiation therapy is typically used as an adjuvant treatment immediately following surgical removal to prevent keloid recurrence. It inhibits fibroblast proliferation, preventing new scar tissue from forming. Radiation therapy significantly lowers recurrence rates compared to surgery alone, with best results often achieved when administered within 24-48 hours post-surgery.
Silicone sheeting or gels
Silicone sheeting or gels are a non-invasive option used after other treatments or for prevention. These products create a hydrated environment over the scar, softening the tissue, reducing collagen overproduction, and improving scar appearance. They are typically worn for extended periods, usually several months, for optimal results.
Pressure dressings or garments
Pressure dressings or garments apply continuous pressure to the keloid, helping to flatten and soften the scar by decreasing blood flow and collagen production. This therapy is most effective when started early and worn consistently for many months.
Home and Over-the-Counter Approaches
While professional medical treatments are generally more effective for established keloids, some home and over-the-counter methods can offer minor improvements or symptom relief. These approaches are less potent and may not significantly reduce the size of a developed keloid. Consult a healthcare professional before relying solely on these methods.
Topical creams and gels
Topical creams and gels containing ingredients like onion extract or vitamin E are marketed for scar treatment. Onion extract has shown anti-inflammatory and collagen-suppressive properties in studies, and some research suggests it can improve scar color, especially when combined with silicone. However, human studies show mixed results regarding its effectiveness for scar height or itching. Similarly, there is limited clinical evidence that vitamin E significantly reduces the appearance of existing scars.
Massage
Massage can be gently applied to keloids once the wound has healed. This technique aims to break down collagen fibers and improve blood circulation, potentially leading to a softer, flatter scar. Consistent massage over time may contribute to minor improvements in scar texture.
Moisturization
Moisturization supports skin health around a keloid. Keeping the skin hydrated may help with flexibility and reduce dryness or itching. While moisturization alone will not resolve a keloid, it can be a supportive measure in overall skin care.
Preventing Keloid Formation
Preventing keloid formation or recurrence is crucial for individuals prone to these scars. Proactive measures can significantly reduce the risk after any skin injury or procedure on the nose.
Proper wound care
Proper wound care is fundamental to minimize scarring. This involves gently cleaning the injured area with mild soap and water, and keeping the wound moist with petroleum jelly and a bandage until it heals. Avoid harsh antiseptics like hydrogen peroxide or rubbing alcohol, as they can irritate healing skin.
Avoiding unnecessary skin trauma
Avoiding unnecessary skin trauma is a key preventative step. For individuals prone to keloids, reconsider non-medical procedures like body piercings or tattoos on the nose, as these can trigger keloid development. Protecting wounded skin from sun exposure is also important, as UV rays can darken scars and impede healing.
Informing medical professionals
Informing medical professionals about a history of keloids is essential before any planned surgeries or procedures on the nose. Surgeons can then employ specific techniques to minimize skin tension during the procedure and plan for post-operative preventative measures.
Early intervention
Early intervention with preventative treatments can be beneficial for high-risk individuals. Applying silicone sheets or gels to a healed wound as soon as the scab falls off can help prevent keloid formation. If early signs of thickening occur, removing jewelry and considering a pressure device may help prevent a full keloid from developing.