Keeping Away Keloids

You have growths on your chest. They get itchy but they don’t hurt. You have family members with similar growths. The condition is referred to as keloids.

A keloid is the term given to the prominent, irregular scar tissue, which sometimes forms after a person has suffered a small cut or a scratch in the skin. Usually a bump appears at the site of the injury. The bump becomes larger and over time a full-blown (and unsightly) keloid develops. Sometimes keloids develop without injury to the skin.

The good news is that keloids are harmless and do not have the potential to be cancerous or cause some other condition. The bad news is that keloids are unattractive. For reasons we don’t understand the healing process has gone overboard. Keloids continue to grow after the original wound has healed. That’s why they form bumps on the flat surface of the skin.

Keloids are shiny, smooth and rounded. They may be pink, purple or brown. They can be doughy or firm and rubbery to the touch. They can often feel itchy, tender or uncomfortable. A large keloid over a joint may interfere with joint function.

Some people are prone to keloids and develop them in several places on the body. They can crop up anywhere but they commonly appear on the shoulders, upper back and the chest.

Keloids usually appear between the ages of 10 and 30. They affect both sexes equally, but they may be more common in women with pierced ears. Keloids are common among African-Americans. They also tend to run in families.

Keloids may continue to grow slowly for weeks, months or years. They eventually stop growing, but do not completely disappear on their own. Once a keloid develops, it is permanent unless removed or treated successfully. Keloids that are removed often come back.  

The problem is that when you suffer a wound, cells within the skin called fibroblasts deposit connective tissue to hold the wound closed, creating a scar. With keloids, the fibroblasts continue to make tissue even after the wound is filled.

Because scientists don’t know how to turn off the fibroblasts, most treatments have been partially effective. In fact, for most available treatments, the recurrence rate is 50 percent.

One of the most important things you can do to prevent keloids is to take care of abrasions and cuts. For example, any cut that may require stitches should be stitched up right away.

There are several options your doctor may choose to treat your keloid including

·       Injection of the keloid with steroid solutions. Steroids cause tissues to become atrophic (thin).

·       Surgery of the keloid with use of steroid injections. In this case, the keloid is injected several weeks prior to surgery. The keloid material is removed and the wound is carefully sutured. Steroids are again injected and continued for several weeks after.

·       Surgery of the keloid followed by radiation therapy. Patients receive superficial radiation to the affected area.

·       Freezing the scar. Small keloids can be reduced or removed by freezing them with liquid nitrogen

·       Laser treatment. Large keloids can be flattened by pulsed dye laser sessions.

·       Silicone gel sheets. These are applied directly to the skin around the surgical incision.

May reduce the size of the keloids over time.

Whatever treatment option you use, keep in mind that the keloid can come back larger (this is especially true with surgery. Injectable medicines like corticosteroid triamcinolone (Kenalog) work to flatten the keloid scar, rather than remove it. Then there is compression therapy to mechanically flatten the scar formation. And there is a tape impregnated with steroids, where you place the tape on the keloid and the steroid is slowly released. The idea is if you do take the surgical route, you get other treatments like the injectables or laser to complement it.

Whatever plan you and your doctor agree upon, please know that it will take time to see measurable results. That’s several sessions before you’re able to discern any difference with your keloids.

There is no “magic bullet” cure for keloids. But there is a plethora of treatment options to reduce or remove them. Discuss those options with your doctor to decide what is best for you.