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When I had a little skin tag removed from my chest about 20 years ago, I did not know that I was subject to keloids, a kind of scar in relief. But I developed one just where the skin tag was, and looking back, I did not know I would have removed the label if I had known that a keloid was a possible side effect.
The keloid of an inch long is right in the middle of my cleavage and has the shape of a dog bone because it is higher on each side. Sometimes people just watch. Other times, they ask me if I have had heart surgery (this is not the case), thinking it is a postoperative scar. A creative girl asked herself if it was a single type of tattoo and encouraged me to come up with a story to tell others.
If, like me, you wonder how keloids are formed and what you can do about them if you have one, here's what you need to know.
What are the keloids scars anyway?
Any scar is the normal and healthy attempt of the body to repair a wound to the skin. But a keloids is a more thangrowth of scar tissue. Keloids can develop after surgery (including cesarean sections) or skin trauma, including wounds, tattoos and piercings. They can also occur after acne breakouts, says Katy Burris, MD, a dermatologist in the Department of Dermatology at the Columbia University Medical Center. Sometimes keloids are formed without a clear cause, according to the American Academy of Dermatology (AAD).
They tend to be thick, pink or brown and can look like a bar, says Dr. Burris at SELF. Keloids develop slowly for several months and, unlike other types of raised (hypertrophic) scars, keloids exceed the limits of the original skin injury, SELF Jason M. Preissig, MD, a dermatologist at Mercy Medical, told SELF. Baltimore Center.
Experts do not fully understand why keloids are formed, but there seems to be a genetic componentIf you have a first-degree relative who catches keloids, you're also more likely to have them, says the DAA. And people of African-American, Asian or Hispanic ethnicity are also more likely to develop keloids.
Normally, biological mechanisms are in place to regulate the processes of repair and regeneration of the tissues in the healing skin. But when a keloid is formed, it's a sign that something is wrong with that balance. Laboratory research suggests that abnormalities in the production of melanocytes that stimulate the hormone and collagen in the skin as well as effects of stress on hormonesand prolonged inflammation at the site of the injury may contribute to the formation of keloids. But we are still far from really understanding exactly why and how they are produced.
Even people who are prone to keloids do not always have them after a skin injury. The factors that determine whether you develop a keloid or a "normal" scar are not fully understood, but we know that keloids are more likely to develop on certain parts of the body (such as the ears, shoulders, chest , neck, etc.). back) and under certain conditions (for example, if the injury has had an extended healing time).
The good news is that keloids do not necessarily worry you. "They are not an infection, they are not contagious and they are not related to cleanliness," says Dr. Preissig. "They happen just at random." Although keloids are not harmful, they sometimes cause pain or itching. (The only time I was hurt after my son was born and held it against my chest, he naturally wanted to touch the keloid area.)
However, it's a good idea to consult a dermatologist if you have a keloid, says Dr. Burris. On the one hand, it is important to make sure that it is a good keloid and not another type of raised skin problem. And if you decide you want to treat your keloids, the sooner you start treating them, the better the chances of the treatment working.
Treating keloids can be difficult, but there are several options.
Do not forget that keloids are not harmful nor a sign of cancer. There is therefore no medical reason to have them removed. But if you want to pursue the idea because they annoy you or if you just do not like their appearance, there are some options.
At first, you might be tempted to try over-the-counter options, including topical silicone leaves and gels. These should usually be applied at least once a day and used continuously for months to get results, SELF explained previously. These are also more effective when the scars are new, and your dermatologist may advise you to use them in combination with another treatment, such as a compressive bandage that reduces blood flow to the area so that you can get better results. prevent the formation of a keloid.
But most often, dermatologists recommend going directly to corticosteroid injections in the keloid area, says Dr. Preissig. This will not remove the keloid, but it can help to reduce it break the bonds between collagen fibers and providing an anti-inflammatory effect. According to Dr. Burris, this is the most common treatment, noting that most people notice a difference. But it could take an injection once a month for four to six months to have the effects.
If your keloid is particularly thick or large, steroid injections may not be enough on their own, says Dr. Preissig. In this case, your dermatologist may recommend the use of injections of 5-fluorouracil, a chemotherapy drug. used locally to treat actinic keratosis (pre-cancerous squamous skin) as well as certain types of skin cancer. "Keloids are not cancer, but this type of injection has been very effective," says Dr. Preissig. It can be used alone or with steroid treatments.
It is also possible to shave or completely excise a keloid so that it is less visible. But in many cases, again, the keloid comes back, says Dr. Burris. This is the reason why many dermatologists recommend combining treatments, such as compression, silicone sheets, injections and surgery in the same patient.
Laser therapy is another option, which involves exposing the scar to a high-energy beam of light that then restarts the healing and exfoliation process, resulting in improved texture and skin pigment. But laser treatments tend to be expensive and many results may be needed before you can get results. Although lasers can usually thin the scars who have completely healed, he always helps to start treatment as early as possible in the process.
Other options include radiotherapy and cryotherapy treatment. Radiation therapy, which includes radiotherapy and internal radiotherapy (brachytherapy), in particular, is not used so often because of the possible side effectsPhysicians will carefully weigh the pros and cons of this approach before recommending it.
In cryotherapy, the keloid is exposed to extremely cold temperatures, which causes a process called "cryonecrosis" (literally injuring the cells of the skin by freezing them). This type of therapy has proven effective in reducing the size of keloids. after several sessionsespecially when combined with steroid injections, but it is also known to cause pain and loss of pigment in the area.
Regardless of the type of treatment you choose, there is a chance that the keloid will regrow, according to the DAA. With surgery alone, it's valued between 55 and 100% of keloids will reproduce. And the estimates vary considerably for other types and combinations of treatments, so it is essential that you discuss with your doctor the best options for your specific case.
If you are subject to keloids, here are some things to keep in mind.
Use caution before elective skin surgery, including breast augmentation, tattoos or piercings, as you are likely to develop keloids after these procedures.
That said, it does not always guarantee that you will have a keloid after the surgery. For example, basal skin cancer was removed from the nose in 2018 and my dermatologist was concerned about the formation of keloids (although they are much less common on the face). But I recovered well and did not develop keloids as a result of this operation.
If you need to undergo skin surgery, tell the surgeon if you are prone to keloids, so that it can help you reduce your risk of forming more keloids. They may be able to inject corticosteroids into the area before surgery prevent a keloid, for example. And then, it is crucial to follow all post-surgical instructions with diligence. Often, using Vaseline or silicone gels, as recommended by your doctor, can help keep the wound calm and heal without keloid formation, Dr. Preissig says.
In the end, keloids are usually not of concern. But if they cause you discomfort or if you simply prefer to have them removed for any reason, consult a dermatologist.
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