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- KELOID SCAR
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- Persistently heavy scars called keloid scars have two main predisposing factors. The first is the location of the scar and the second the genetic background of the patient.
Keloid scars are more likely to develop in the earlobe, along the border of the jaw, the shoulder and the skin over the breast bone. They often appear after ear piercing.They are more common in the upper part of the body and are rare in the eyelids, soles of the feet, palms of the hand and genitals.
They are uncommon in people with fair skin. They are more likely to develop hypertrophic or thick scars which eventually fade. The difference between these two types of scar is often hard to determine.
In some social groups keloids are deliberately produced as a form of ornamentation of the skin.
There is a genetic tendency for these to form but the exact pattern is not known. They are more common in patients with dark skin. Women are more likely to develop heavy scar as are young people under the age of about thirty.
Heavy scar is more likely to form when the wound is closed under tension or where there is an infection or hematoma(bleeding) after surgery If a foreign body is present in the wound, as may occur after an accident, keloids also seem to be more likely.
In cosmetic surgery some scars are more likely to become thicker, these include the scars associated with : otoplasty(ear pinback), breast reduction and abdominoplasty (tummy tuck)
The treatment of keloid scars is complex and is not always successful. Steroid injections, applications of pressure or silicone sheets, radiation and scar revision surgery are sometimes needed.
Unfortunately all scars are permanent and there is no technique to remove them completely. A plastic surgeon tries to conceal the scar by "revising" it. This often means removing the scar and trying to repair it in such a way as to make an improvement in its appearance. If you are a true keloid former there is no good treatment but hypertrophic scars which appear very similar can often be improved with scar revision. It is fair to think of revision using the 99 rule, that is you have 90% chance of improvement 9% chance the scar will be about the same but a 1% chance it will be worse.
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