Keloids Explained through Answers to Five questions

One of the common skin conditions which i come across is Keloids. They are not only unsightly in appearance but can also be annoyingly itchy and bothersome. Here are a few commonly asked questions and the queries

Q- What exactly is a keloid?

Ans – During the process of wound healing, granulation tissue consisting of collagen fibres are laid down to bridge the wound. When this scar tissue overgrows, it forms what we know as keloids.

Q- What are the predisposing conditions for keloid formation?

Ans- There are a few predisposing factors which increase the tendency of keloids
a)Afro Carribean population is more prone to keloids than Caucasian.
b)Wounds healing under tension or which get secondarily infected are at a higher risk
c)Certain sites like sternum ( breastbone) , backside of ear lobe can develop keloids easily
d)Burns and acne scarring can also develop keloids
e)More is common in younger age group although can be found in any age group

Q- Can a keloid turn cancerous or malignant?

Ans- Fortunately a keloid rarely ever turns malignant or cancerous. It is otherwise harmless
Q- Can a keloid be totally removed or cured?
Ans – This is perhaps the most asked question regarding the keloids. They can be treated and made smaller but cannot be removed totally.
1)Injections of a steroid (triamcinolone) into a keloid may help to flatten small early ones.
2)Steroid-impregnated tape applied for 12 to 24 hours a day may help to flatten keloids.
3)Freezing with liquid nitrogen or crotherapy may also stop early keloids from growing.
4)Putting a silicone sheet over them at night for several months helps some keloids to flatten. Silicone in gel form is also available. Long-term compression with pressure bandages sometimes helps too.
5)Laser treatment makes keloids less red, but does not make them smaller.
6)If a keloid is cut out, it usually comes back, and may end up larger than before. This risk falls if the area is treated after the operation with pressure dressings or local steroid injections.
7)Sometimes, 5-fluorouracil and imiquimod are used to reduce size either alone or before using other types of treatment.

Q- What precautions should I take to avoid increase in number or spread?

Ans-1) Always inform your surgeon about your tendency for keloids.
2) Avoid cosmetic surgery if possible
3) Avoid body piercing or tattoos around ear lobes or shoulder blade
4) Avoid trauma to minimise the risk
5) Treat your acne aggressively and well in time

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