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Keloids Treatment in Hyderabad | Neuderm

Keloids and hypertrophic scars are types of excessive scar tissue that form as a result of wound healing. Both conditions involve the overproduction of collagen, but they differ in appearance, behavior, and treatment. This comprehensive guide explores the causes, symptoms, diagnosis, and treatment options for keloids and hypertrophic scars, as well as their prevention and impact on daily life.

What Are Keloids and Hypertrophic Scars ?

Keloids are raised, thickened areas of scar tissue that extend beyond the original wound boundary. They can continue to grow over time and often have a shiny, smooth surface. Keloids are typically larger than the original injury and can be painful or itchy.

Causes of Keloids and Hypertrophic Scars

Both keloids and hypertrophic scars result from an overproduction of collagen during the healing process. Several factors can contribute to their development:

  1. Genetic Predisposition: A family history of keloids increases the likelihood of developing them. Certain ethnic groups, particularly those with darker skin, are more prone to keloid formation.

  2. Type of Injury: Burns, surgical incisions, piercings, acne, and traumatic injuries can lead to the formation of keloids and hypertrophic scars.

  3. Location of Injury: Areas of the body subjected to higher tension and movement, such as the chest, shoulders, and upper back, are more susceptible to developing these scars.

  4. Infection or Inflammation: Infections or prolonged inflammation during the healing process can increase the risk of abnormal scarring.

  5. Age: Younger individuals, particularly those between the ages of 10 and 30, are more likely to develop keloids.

Symptoms of Keloids and Hypertrophic Scars

Keloids

  • Appearance: Keloids are raised, firm, and smooth, often with a shiny surface. They can be pink, red, or darker than the surrounding skin.

  • Growth: They extend beyond the original wound and can continue to grow over time.

  • Symptoms: Keloids may cause pain, itching, and tenderness. They can also restrict movement if they form near a joint.

Hypertrophic Scars

  • Appearance: Hypertrophic scars are raised and red but remain within the boundaries of the original wound. They may become paler and flatter over time.

  • Symptoms: These scars can be itchy and painful, especially in the early stages of healing.

Diagnosing Keloids and Hypertrophic Scars

Diagnosis of keloids and hypertrophic scars is primarily based on their appearance and the patient’s medical history. A dermatologist or healthcare provider will examine the scar and ask about the nature of the injury and any family history of abnormal scarring. In some cases, a biopsy may be performed to rule out other conditions and confirm the diagnosis.

Treatment Options for Keloids and Hypertrophic Scars

The goal of treatment is to reduce the size, appearance, and symptoms of the scar. Treatment options vary depending on the type and severity of the scar, as well as individual patient factors.

Non-Surgical Treatments

  1. Corticosteroid Injections: Steroid injections can help reduce inflammation and flatten keloids and hypertrophic scars. Multiple injections may be needed over several months.

  2. Silicone Gel Sheets: These sheets can be applied to the scar to soften and flatten it over time. They are often used in conjunction with other treatments.

  3. Pressure Therapy: Applying pressure garments or bandages to the scar can help reduce its size and thickness.

  4. Cryotherapy: Freezing the scar with liquid nitrogen can help reduce its size, especially for smaller keloids.

  5. Laser Therapy: Pulsed dye lasers and other laser treatments can reduce redness and flatten scars. This treatment is often combined with other therapies.

  6. Intralesional Injections: Injections of medications such as 5-fluorouracil (5-FU) or bleomycin can help reduce scar tissue.

Surgical Treatments

  1. Excision: Surgical removal of the scar tissue can be effective, but there is a risk of recurrence, especially with keloids. Combining surgery with other treatments, such as steroid injections or radiation therapy, can reduce this risk.

  2. Radiation Therapy: Low-dose radiation therapy following surgical excision can help prevent the recurrence of keloids.

  3. Cryosurgery: This involves freezing the scar tissue with liquid nitrogen, which can be effective for smaller keloids.

Other Treatments

  1. Topical Treatments: Medications such as retinoids or imiquimod cream can be applied to the scar to help reduce its size and improve appearance.

  2. Scar Massage: Regularly massaging the scar with appropriate creams or oils can help improve its texture and flexibility.

Prevention of Keloids and Hypertrophic Scars

Preventive measures can help reduce the risk of developing keloids and hypertrophic scars, especially for those with a predisposition to abnormal scarring:

  1. Wound Care: Proper wound care is essential. Keeping the wound clean and moisturized, avoiding picking or scratching, and protecting it from infection can promote better healing.

  2. Avoid Unnecessary Procedures: Avoid elective surgeries, piercings, or tattoos if you have a history of keloids or hypertrophic scars.

  3. Pressure and Silicone Therapy: Using pressure garments or silicone gel sheets on healing wounds can help prevent abnormal scar formation.

  4. Sun Protection: Protecting the scar from sun exposure can prevent it from becoming darker and more noticeable.

Psychological Impact and Coping Strategies

Keloids and hypertrophic scars can have a significant psychological impact, particularly if they are highly visible or cause discomfort. Coping strategies include:

  1. Education: Learning about the condition and understanding that it is a common response to injury can help reduce anxiety.

  2. Support Groups: Connecting with others who have similar conditions can provide emotional support and practical advice.

  3. Counseling: Professional counseling or therapy can help individuals cope with the emotional and psychological effects of visible scars.

  4. Camouflage Makeup: Special makeup designed to cover scars can improve appearance and boost confidence.

Research and Future Directions

Ongoing research aims to improve the understanding and treatment of keloids and hypertrophic scars. Areas of interest include:

  1. Genetic Studies: Understanding the genetic basis of keloid formation can lead to better prevention and treatment strategies.

  2. Advanced Therapies: New treatments, such as targeted molecular therapies and biologics, are being investigated for their potential to reduce

    scar formation.

  3. Improved Laser Technologies: Advances in laser technology may offer more effective and less invasive treatment options.

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