Keloids are raised, firm scars that can develop after skin injuries, often appearing on visible areas like the nose. They represent an overgrowth of scar tissue, extending beyond the original wound boundaries. This article explores the characteristics of keloids and various professional and preventive strategies for their treatment.
Understanding Keloids and Their Formation
Keloids are characterized as raised, often discolored scars, appearing red, pink, purple, or darker than the surrounding skin. They can feel firm, lumpy, or rubbery and may cause itching or discomfort. Unlike hypertrophic scars, which remain confined to the original wound area and may fade over time, keloids grow beyond the initial injury site and typically do not regress spontaneously.
The formation of a keloid involves an abnormal healing response where the body produces an excessive amount of collagen, a protein that provides skin structure. This overproduction of collagen by fibroblast cells leads to the characteristic raised appearance. Contributing factors include genetics, with individuals of African, Asian, and Hispanic descent having a higher predisposition. Skin trauma, such as piercings, cuts, burns, acne, or surgical incisions, can trigger keloid development.
Keloids are particularly common on the nose due to its cartilage structure and frequent exposure to minor injuries or piercings. Nose piercings are a common trigger for keloid formation in susceptible individuals. The continuous tension on the skin in certain areas, including the nose, can also promote excessive scar tissue growth.
Professional Treatment Approaches
Multiple medical treatments are available for keloids, often employed in combination for improved outcomes. Corticosteroid injections, typically using triamcinolone acetonide, are a common first-line treatment. These injections reduce inflammation and collagen production within the scar, leading to flattening and softening. Multiple injections are usually required, spaced several weeks apart.
Surgical excision involves removing the keloid. However, surgery alone carries a high recurrence rate (45-100%), so it is often combined with other therapies to minimize recurrence. Cryotherapy, which involves freezing the keloid with liquid nitrogen, causes cellular injury and necrosis. This method reduces scar prominence and is often applied in multiple sessions, sometimes combined with corticosteroid injections.
Laser treatment, using pulsed dye lasers, can reduce redness and flatten keloids. Lasers improve scar appearance and are frequently used as part of a broader treatment plan. Radiation therapy, particularly low-dose external beam radiotherapy, is often used after surgical removal to prevent recurrence. This therapy targets scar tissue to inhibit growth and shows high success rates when combined with surgery.
Silicone sheeting and gels are also recommended as part of a treatment regimen. These products create a protective, moist environment over the scar, helping to soften, flatten, and improve the color and texture of keloids. They are often applied daily for several months. A combination of these treatments, such as surgery followed by radiation or injections, is generally considered the most effective strategy to manage and reduce recurrence.
Managing and Preventing Recurrence
Preventing keloids from returning after treatment requires diligent post-treatment care. Following a doctor’s instructions is important, including using pressure dressings, silicone sheets, or gels. These methods help maintain pressure and hydration on the healing area, regulating collagen production and reducing scar thickening.
Minimizing skin trauma is a primary prevention strategy for individuals prone to keloids. This includes avoiding unnecessary piercings and tattoos. Proper wound care, such as gently cleaning cuts or injuries, applying petroleum jelly to keep the wound moist, and covering it with a bandage, helps reduce keloid formation risk. Protecting healing skin from sun exposure is also advised, as UV rays can darken scars and hinder healing.
Early intervention is beneficial; consulting a dermatologist or plastic surgeon at the first sign of keloid formation or any suspicious scars can lead to timely preventive measures. For some individuals, keloids can be a chronic condition requiring ongoing vigilance and regular follow-up with medical professionals to manage potential recurrences. Maintaining a healthy lifestyle, including a balanced diet and hydration, supports overall skin health and healing processes.