Keloids

A scar, otherwise known as a keloid scar, is a convex scar that covers an area larger than the wound from which it formed. It appears at the site of a skin damage within weeks or even months after the damage occurs. A scar is highly vascularized and never disappears on its own.

Scarring occurs most often as a result of:

• skin injuries such as cuts, abrasions or scratches,
• burns,
• at the vaccination site,
• after ear piercing
• as a result of abnormal healing of acne or chickenpox,
• after cesarean section.

In very rare cases, keloids form on intact skin called spontaneous keloids.

Among whom do scarring occur?

It is believed that scarring occurs among people who have a genetic tendency to develop it. In addition, they are more common in people who have a family history of scarring, are between the ages of 10 and 30, and are of African, Asian or Hispanic descent.

Where do scars appear?

Scarring can occur on almost any part of the body, but it is especially common on the ears, neck, shoulders, chest and back. In rare cases, a keloid forms on the eyelid, genitals, hand or sole of the foot.

How do you recognize a scar?

Scars vary in size and shape depending on where they occur on the skin. They can be very small or occupy a large area of skin. The largest keloids usually form on the arms and back.

Characteristics of scarring:

• Scar tissue usually develops slowly. It can take as long as 12 months after a skin injury before an unsightly scar appears. However, there are cases of extremely rapid scar growth.
• It usually appears as a convex pink, red or purple scar. On the earlobe, it takes on a round shape, and on the chest, legs, or arms, it may look like spilled fluid solidified on the skin.
• A scar tissue may feel soft like dough or hard and rubbery to the touch. Its surface is different from the surrounding skin.
• The Patient may experience pain, itching, and tenderness of the skin at the site of scar growth. When the keloid stops growing usually these symptoms stop.
• Over time, the scar takes on a darker color than the surrounding skin.

Diagnosis and treatment of scarring

Treatment of scarring is provided by a dermatologist, who usually makes a diagnosis based on the clinical appearance of the keloid. Occasionally, the physician may order a skin biopsy to rule out cancer.

Different methods are used to treat keloids depending on the location of lesion, type of scar and age of the Patient. Scarring tends to recur, so using two or more treatment methods increases the effectiveness of treatment.

The choice of treatment for a scar often also depends on the effect the Patient would like to achieve first – i) relief of symptoms such as pain or itching, ii) flattening or softening of the keloid, iii) complete elimination of the scar.

The most common treatments for scarring:

• Laser therapy that breaks down the collagen fibers that are the building blocks of scar tissue. The scar gradually shrinks and brightens. This therapy is considered to be one of the most effective treatments, as it provides rapid results in over 60% of Patients. Good results are achieved after just a series of 3-5 treatments, and full skin renewal results are achieved within 4-6 weeks after treatment. The treatment lasts from 10 minutes to 1.5 hours depending on the area of irradiation. Laser therapy is often combined with corticosteroid therapy, which allows to achieve high effectiveness of treatment.
• Injections of corticosteroids and other medications. This therapy is effective for 50% to 80% of scars. A series of corticosteroid injections reduces, softens, and brightens the lesion, and there is little risk of the scar recurring after this treatment. The skin may become thin and pale at the site of injections.
• Surgical removal of a scar. After excision of the lesion, the Patient must wear a compression earring, bandage, or compression garment for 6 to 12 months, which is very inconvenient for most Patients. Failure to follow these instructions results in recurrence of the scar.
• Cryotherapy. Freezing the scar causes it to soften and shrink. Cryotherapy has good results for small keloids. It can lead to the disappearance of pigment in the frozen treatment area.
• Radiation therapy. This method of treatment is most often used after surgical removal of the lesion to prevent recurrence of the scar. This therapy is associated with a certain risk of cancer development, and therefore is rarely used.
• Moisturizing oils and ointments with plant extracts, allantoin, heparin or its derivatives, and with silicone. Oils and ointments can be effective if the Patient starts using them immediately after the wound has healed.

It is important to remember that the effectiveness of scar treatment largely depends on the Patient’s adherence to the dermatologist’s recommendations. Failure to follow the guidelines often results in recurrence of the troublesome scar.

Treatment of scarring in the Zakrzewscy Clinic of Aesthetic Medicine and Dermatology

In Zakrzewscy Clinic we use two methods currently considered to be the most effective in treating scarring: laser therapy with the use of a modern surgical Alma Pixel CO2 laser and corticosteroid injections (Kenalog). The combination of these two therapies allows for complete or significant reduction of bothersome scars.

Advantages of using laser in treating scars in Zakrzewscy Clinic:

• The laser beam causes disintegration of collagen fibers, which are the building blocks of the scar, and as a result its gradual shrinkage and brightening.
• 10 minutes – this is how long a single treatment usually takes in case of small scars. The radiation time is correspondingly longer if the skin lesion is extensive.
• 3 to 5 treatments allow for a visible reduction in scarring.
• The procedure is very precise and delicate (performed using a microscope and strong lighting), which significantly reduces the recovery period.
• The procedure is performed under local anesthesia, making it painless and safe for people with chronic diseases and for pregnant women.
• The use of local anesthesia means that the Patients can eat and drink before the procedure and return to their daily activities immediately after the procedure.
• Minor side effects such as swelling and redness at the radiation site usually disappear 3-5 days after treatment.
• During the therapy, the Patients remain under the constant care of the Clinic, and their condition is subject to observation according to health monitoring schedule.

If you are bothered by a scar or concerned about the condition of your skin and would like to obtain professional consultation and treatment, feel free to contact our Clinic at 32 6100 690.

You can find more about treatment with Alma Pixel CO2 laser in our Zakrzewscy Clinic at https://www.klinikazakrzewscy.pl/oferta/laseroterapia-i-urzadzenia-hi-tech/laser-frakcyjny-pixel-co2.

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