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Keloid Scars

Keloid ScarA Keloid scar also known as Keloidal Scar can be put into two categories depending on their maturity. 1) 111 (early type) or 1 (late type) collagen. 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 can be firm rubbery legions or they can be shiny fibrous nodules. Their colour can vary from pink to the colour of the patient’s skin or from red to a dark brown colour. A Keloid scar is not malignant nor is it contagious, it can however get very painful and very itchy. It can also change in texture. In severe cases of Keloid scars, it can affect the movement of the skin. Keloid scars are more prominent in ethnic groups than they are in Caucasians.

Keloids are not hypertrophic scars, which are scars that are raised scars that do not grow over and beyond the original wounds boundaries.

Signs and symptoms
Keloid scars grow over normal skin in claw like growths. They tend to itch badly and without warning. The pain from Keloid scars have been described as needle like pain. The amount if itching or pain varies from person to person. If a Keloid scar becomes infected it could ulcerate. You could remove the scar surgically, but the chances are 50% that a Keloid scar will form over the resulting surgery scar. Laser treatment has been used and has had varying degrees of success.

Keloids form within scar tissue. Collagen which is used to repair scars tend to overgrow in this area, and this in turn produces a lump that is many times larger that that of the original scar. Keloid scars are known to occur on the original scar but have been known to appear spontaneously. They can form from something as small as a pimple site or even a piercing, or even on a scratch. They can even occur as a result of severe acne and even from chicken pox scarring, from infection at the site of a wound, or trauma caused repeatedly to one area, or if the skin has excessive tension whilst the wound is closing. Chlorine could aggravate the Keloid scar. If the Keloid scar appears on a young person, it will grow as the person grows.

Location
Keloid scars develop anywhere where an abrasion has occurred. Any trauma to the skin for example pimples, insect bites, scratches and burns can result in the development of Keloid scars. They can even develop after surgery. The most common places that they develop are on the chest, the back and shoulder area and on the ear lobes. They also occur on body piercings or on the arms, the pelvic region and over the collar bones.

Cause
Keloids are caused when metals with lower grades than surgical grades are used, for example, in piercings and implantations. There is some speculation that fibroblasts, MMP-2 (Matrix Metalloproteinase-2) and or TIMP (Tissue Inhibitors of Metalloproteinases) could also have some relation to the cause of Keloid scars.

Epidemiology

Even though Keloid scars can develop on people of any age, it has been proven that children under the age of 10 are less likely to develop Keloid scars, even from piercing. Keloids can also develop when a person continues to shave when they have razor bumps. If you do get razor bumps it is recommended that you stop shaving and allow the bumps to heal before trying alternative forms of hair removal. There is also speculation that Keloids are hereditary. Keloids have also been known to grow without piercing the skin, growing similar to a slow tumorous growth, the reason why this happens is still unknown. If the Keloid scar grows too big it will have to be removed surgically or in worst case scenario amputation might be the only solution.

History
The first mention of Keloid scars has been dated back to 1700BC by Egyptian surgeons. In 1806 Baron Jean-Louis Alibert identified the Keloid as an entity. To avoid confusion with cancer, he had to change the name from cancroide to cheloid. Cheloid was derived from the Greek language. Alibert’s clinic at the Hospital Saint-Louis was the worlds centre for dermatology for many years.

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