Brief overview
- What is a keloid (scar keloid)? A keloid is a benign proliferating scar. It rises tumor-like above the surrounding healthy skin and overlaps the scar area.
- Symptoms: Keloids may itch and be sensitive to touch and pressure. Sometimes spontaneous pain occurs. Functional limitations (e.g., mobility) are also possible.
- Treatment: various methods, e.g. silicone treatment, cortisone injections, icing, laser treatment, surgery.
What is a scar keloid?
Keloids are scars whose tissue grows excessively and can rise up to half a centimeter (sometimes even more) above the surrounding healthy skin. Unlike hypertrophic scars, in which the excessive cell growth remains confined to the scar area, a keloid proliferates beyond it. This scar proliferation can continue to grow over the years. A keloid does not regress on its own.
Keloid is a benign scar tumor – in contrast to scar carcinoma. This is a rare, aggressive form of skin cancer that can develop as a result of constant skin irritation (e.g. friction) from a poorly healing scar (unstable scar), fistula or ulcer.
Keloid: causes and risk factors
Keloid: Symptoms
A keloid is initially reddish or brown-red in color, later whitish-red or pink. The overlying skin is smooth, and the growth varies in thickness and is plate- or nodule-shaped. It stands out clearly from its healthy surroundings and can grow rapidly.
Scar keloids often develop in the shoulder region, on the chest, back or earlobes. Affected persons often perceive the scar growths as not very aesthetic and psychologically stressful.
Keloid: Treatment
Treatment is not always successful, often keloids do not respond well to it and can only be flattened somewhat, but do not disappear completely. In addition, the therapy can be very lengthy.
There are several methods to treat keloids. Which of them can be considered in individual cases depends on various factors such as:
- Age of the patient
- Skin type
- The part of the body where the keloid is located
- Extent of scarring
Silicone treatment
The silicone is applied to the scar proliferation, for example in the form of thin pads, foils or gel, usually for 12 to 24 hours per day for three to six months. Exactly how the silicone works has not yet been clarified. However, experts assume that the moisture content of the skin improves under the silicone. This is said to reduce scar thickness and itching.
Glucocorticoid injections
Synthetic glucocorticoids (colloquially “cortisone”) inhibit the formation of new connective tissue. For this purpose, the doctor injects them directly into the scar tissue. If necessary, the injection is repeated at three- to four-week intervals. The glucocorticoid triamcinolone (TAC) is most commonly used to remove a keloid.
The method is painful and takes several months. However, it is comparatively effective.
Icing (cryosurgery)
Icing can also be used to remove a keloid. For this purpose, liquid nitrogen is introduced into the scar tissue. This causes the tissue to freeze from the inside out and the scar to shrink. For an optimal result, however, icing must usually be repeated at intervals of several weeks.
Pressure treatment
Local pressure on the scar area can reduce blood flow in the scar tissue, accelerate the maturation of collagen and thus flatten the scar. local pressure on the scar. For this pressure treatment, elastic tissue is usually used (e.g. compression bandage, stocking, suit), sometimes transparent plastic masks or special pressure buttons. The treatment lasts from six months to two years.
Laser treatment
In a non-ablative laser treatment, for example, a dye laser is used to reduce the pathologically increased blood flow in the scar tissue. This can be used, for example, to reduce severe reddening of the scar.
Radiotherapy
Onion extract
5-Fluorouracil
5-Fluorouracil (5-FU) is active substance that, like onion extract, inhibits the maturation of fibroblasts. It is actually approved for cancer treatment. However, outside of this approval (“off label”), it is also used for the treatment of therapy-resistant keloids – scar growths for which other therapy methods are ineffective. For this purpose, 5-FU is injected directly into the scar tissue. The whole procedure is usually combined with other therapy methods.
Operation
Better results can usually be achieved if surgery is combined with other therapeutic methods (e.g. pressure treatment, radiotherapy). Therefore, surgery is not recommended as some form of treatment for keloids.
Keloid: Prevention
A fresh scar should be protected from direct sunlight and severe cold and properly cared for. Those who are known to be prone to the formation of keloids should not have their ears pierced and should also refrain from piercings.
