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There can be a number of problems with scars on the skin. A keloid is an excessive production of scar tissue that can result from acne scarring, a surgical scar or from ear or body piercing. They are more common in darker skin types and certain areas of the body. Keloids can also be itchy or painful.

How are Keloids formed?

When the skin is cut through its full thickness, it responds by undergoing a process of wound healing. Scars can take up to months to properly form, but initially when the skin is cut it bleeds and a blood clot is formed, this can form as a scab.

Fibroblasts produce collagen which replaces the blood clot and forms a scar instead, the way this collagen is produced is different from the way normal skin is produced, and because of this scar tissue, it looks different to normal skin.

Due to the different ways scars form, scar tissue is not as functional as normal skin and sweat glands and hair follicles are not able to grow back on scar tissue.

Dr Ayham Al-Ayoubi explains that a keloid or a keloid scar is a type of scar, which depending on its maturity , is composed of mainly either type three (early) or type one (late) collagen.

A Keloid 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.

How do you know if your scar is a keloid?

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

Who is likely to suffer from Keloids?

Keloid scars are more common in individuals with darker skin tones such as African-American races.

The peak age for a Keloid to form is from 10-30 years old. Hereditary factors could lead to a higher tendency to develop keloids.

When Keloids occur

Keloids can occur anywhere where there is trauma to the skin and are frequently seen in locations where there have been piercings such as the ear lobes.

Keloids typically starts to develop about three months after the original skin damage although it can take up to a year to develop.

The first sign of a Keloid is a rubbery scar tissue which starts growing beyond the borders of the original damage. It could become tender, itchy, painful or even produce a burning sensation.

A keloid can develop even without any apparent skin injury. The most common areas for keloids to develop are the shoulders,neck, earlobes and cheeks, and quite often the  breastbone. It is also possible for keloids to occur spontaneously, these also can be anywhere but have a pre-disposition of occurring on the chest.

Side effects of Keloids

If a keloid is growing over a joint, it can restrict movement. In time, the original red colour changes to brown or becomes pale.

Stretching of the skin could increase keloid formation where a wound has occurred, and sites where keloids commonly form are often subject to stretching and tension with the exception of the ear where there are piercings.

If you are in a high risk group or have already had a keloid, it is advised to avoid body piercing and tattoos. Avoiding unnecessary operations such as cosmetic surgery, especially in those areas of the body where keloids are prone to develop can help reduce your risk.

Those that are prone to acne, should try and ensure that the area is treated effectively at an early stage, ensuring that the spots do not scar.

Those at high risk of developing a keloid and requiring an operation, may be offered dressings, steroid injections or other treatments to help to reduce the risk of keloid developing.

Treatments at LMA Clinic for Keloids

Once a keloid is present, There are a number of treatment options for a keloid scar which includes injections into the scar, laser or intense pulsed light therapy, topical treatment in the form of creams or occasionally re-excising the scar.

Traumatic scars can often be improved by scar revision surgery. This is because a neat surgical scar will heal better than tissue that has been injured, torn or crushed. Scars in some areas can undergo stretch and widen. Once again treatment options are sometimes available for this.

At the London Medical & Aesthetic Clinic Dr Ayham Al-Ayoubi will be able to assess and advise on the best management for a problematic scar Keloid. All treatment modalities available will be discussed in the consultation so that you feel confident in the treatment and aftercare been offered to you,

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