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FAQ – Keloids

Read more about Keloids

Dr Ayham Al- Ayoubi explains that a keloid (also keloidal scar) is a type of scar, which depending on its maturity, is composed of mainly either type III (early) or type I (late) collegen.

It is a result of an overgrowth of granulation tissue (collagen type 3) at the site of a healed skin injury which is then slowly replaced by collagen type 1.

Keloids are firm, rubbery lesions or shiny, fibrous nodules and can vary from pink to flesh-coloured or red to dark brown in colour. A keloid scar is bengin, non-contagious, and sometimes accompanied by severe itchiness and pain, and changes in texture. In severe cases, it can affect movement of skin.

Keloids are raised and look shiny and dome-shaped, ranging in color from pink to red. Dr Ayham Al-Ayoubi explains that some keloids become quite large and unsightly. Aside from causing potential cosmetic problems, these exuberant scars tend to be itchy, tender, or even painful to the touch.

Causes of Keloids

Dr Ayham Al-Ayoubi admits that surgeons and Doctors do not understand exactly why keloids form in certain people or situations and not in others. Changes in the cellular signals that control growth and proliferation may be related to the process of keloid formation, but these changes have not yet been characterised scientifically.

Dr Ayham Al-Ayoubi explains that Keloids are equally common in women and men, although at least in times past more women developed them because of a greater degree of earlobe and body piercing among women.

Keloids are less common in children and the elderly. Although people with darker skin are more likely to develop them, keloids can occur in people of all skin types. In some cases, the tendency to form keloids seems to run in families.

Keloid treatment

Keloids were described by Egyptian surgeons around 1700 BC. Baron Jean-Louis Alibert (1768 -1837) identified the keloid as an entity in 1806. He called them cancro’de, later changing the name to cholo’de to avoid confusion with cancer. The word is derived from the Greek, chele, meaning “hoof”, here in the sense of “crab pincers”, and the suffix -oid, meaning “like”. For many years, Alibert’s clinic at L’Hospital Saint-Louis was the world’s center for dermatology.

Dr Ayham Al Ayoubi explains that there are several treatments available, but none of them has been shown to be more effective than the others. Treatment can be difficult and isn’t always successful. Treatments that may help flatten a keloid include:

  • steroid injections
  • applying steroid-impregnated tape to the area for 12 hours a day
  • applying a silicone sheet to the area at night for several months (however, there is not much evidence that this works)

Other options are:

  • freezing early keloids with liquid nitrogen to stop them from growing
  • laser treatment to lessen redness (this won’t make the scar any smaller)
  • surgery to remove the keloid (however, the keloid can grow back and may be larger than before)
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