Keloids are a type of raised scar that can form after skin injury, appearing as firm, rubbery growths. While generally harmless, keloids can present a cosmetic concern, particularly when they develop on visible areas like the nose. Addressing keloids on the nose often requires professional medical intervention due to their unique characteristics and location. This article explores the nature of keloids, why they commonly appear on the nose, and the various professional methods available for their removal.
What Are Keloids and Why Are They on the Nose?
Keloids are scars that grow beyond the original boundaries of a wound, unlike hypertrophic scars which remain within the injury site. They result from an overgrowth of dense fibrous tissue, primarily collagen, during the healing process. This excessive tissue formation leads to a raised, discolored, and sometimes itchy or tender lesion.
Common causes include skin trauma like surgical incisions, acne, or burns. The nose is a frequent site for keloid formation, especially after nose piercings. Repeated trauma or prolonged inflammation from poorly healed piercings can trigger excessive collagen production. Self-removal attempts are ineffective and can lead to further scarring or infection, necessitating professional medical evaluation.
Professional Removal Options
Treating keloids on the nose often involves a multi-faceted approach, employing various techniques to reduce their size and appearance. The choice of treatment depends on the keloid’s size, age, and location, and individual response. Often, a combination of treatments yields the most favorable outcomes.
Corticosteroid injections are a common first-line treatment, involving direct injection into the keloid. These injections reduce inflammation, inhibit collagen synthesis, and promote existing collagen breakdown. A series of injections, typically every three to four weeks, can flatten and soften the keloid, reducing symptoms like itching or pain.
Surgical excision involves cutting out the keloid. While it offers immediate removal, surgical monotherapy has a high recurrence rate, as surgery can stimulate new keloid growth. Therefore, surgery is almost always combined with other therapies, such as corticosteroid injections, pressure therapy, or radiation, before or after the procedure to minimize recurrence.
Cryotherapy uses extreme cold to destroy keloid tissue. Liquid nitrogen is applied directly to the keloid, causing cellular damage. This method can flatten smaller keloids and may be combined with corticosteroid injections for better results. Multiple sessions are often required for optimal outcomes, spaced several weeks apart.
Laser therapy, such as pulsed dye (PDL) and Nd:YAG lasers, can treat keloids. PDL targets blood vessels, reducing redness and flattening appearance. Nd:YAG lasers can penetrate deeper to reduce keloid bulk. Laser treatments often require multiple sessions and can improve scar texture and color, though they may not completely remove the keloid.
Radiation therapy uses focused radiation beams to prevent cell proliferation and collagen production. It is often employed shortly after surgical excision to significantly reduce recurrence rates. While effective, radiation is generally reserved for larger or recurrent keloids due to potential long-term side effects.
Pressure therapy and silicone gel sheeting are non-invasive treatments, used alone for small keloids or as adjunctive therapies. Pressure garments or devices apply continuous pressure to the keloid, inhibiting fibroblast activity and collagen synthesis. Silicone gel sheets or topical gels, applied directly to the keloid, create an occlusive environment that hydrates the scar and regulates fibroblast activity, leading to a softer and flatter appearance. These treatments require consistent application over several months.
Preventing Keloid Recurrence
Preventing keloid recurrence is key to long-term management, as keloids tend to return even after successful removal. Adhering to post-treatment protocols from your healthcare provider minimizes recurrence risk. This includes diligent wound care and consistent application of prescribed topical treatments.
Minimizing future skin trauma to the treated area is also important. Avoid activities that could cause new injuries, such as further nose piercings or elective cosmetic procedures. Early intervention is another strategy; consult a dermatologist at the first sign of a new keloid or changes in the treated area allows for prompt management. Continued use of scar management products, like silicone sheets or gels, can maintain improved skin appearance and discourage new keloid formation.