WHY DO KELOIDS FORM?
A keloid forms as healing injured skin produces excess connective tissue extending beyond the originally damaged area. Keloids do not flatten or regress like hypertrophic scars, and may grow to unsightly, disfiguring proportions. Time of onset is variable and may be weeks to months after infection or trauma. Keloids occur spontaneously. Although their cause is unknown, keloids tend to form mainly in parts of the body where melanocyte concentration is highest, thus sparing the palms and soles.
WHO IS MORE PRONE TO KELOID FORMATION?
Although people with darker skin are more likely to develop them, keloids can occur in men and women of all skin types. In some cases, the tendency to form keloids seems to run in families.
WHAT ARE THE SIGNS OF A KELOID?
Keloids are raised, often shiny and dome-shaped. Some keloids can become quite large and unsightly. Keloids can be itchy, tender, or painful to the touch.
CAN KELOIDS APPEAR ANYWHERE ON THE BODY?
Keloids develop most often on earlobes, chest, back and shoulders. They typically do not develop on the face with the exception of the jaw area.
DO BODY AND EAR PIERCING LEAD TO KELOID FORMATION?
Keloids can develop following the minor injuries that occur with body piercing. Since the medical world does not understand the exact reasons why some people are more prone to develop keloids, it is impossible to predict whether piercing will lead to keloid formation for one person and not another. One person might, for instance, develop a keloid in one earlobe after piercing and not in the other. Someone who has formed one keloid already should avoid any piercing, especially in body areas prone to scarring.
WHAT IS THE DIFFERENCE BETWEEN A KELOID AND A HYPERTROPHIC SCAR?
After the skin is injured, the healing process usually leaves a flat scar. Sometimes the scar is thickened, or hypertrophic, but is confined to the margin of the trauma area. Unlike Keloids, Hypertrophic scars often subside by themselves (a process which can take one year or more). Treatment such as injections of cortisone can accelerate this process.
Keloids, by contrast, may start some time after the injury and extend beyond the injury site. This tendency to migrate into surrounding areas outside of the injured area distinguishes keloids from hypertrophic scars.
WHAT ARE THE BEST METHODS OF TREATMENT? CAN I EXPECT IT TO RECUR AND WHY?
Excision followed by radiation therapy has been proven to be the most effective treatment. Surgical excision alone has resulted in documented recurrence rates of 50 to 80%. Postexcisional radiation therapy for keloids has been shown to reduce the recurrence rate to 20%. It is suggested that irradiation be initiated within 24 hours of the excision.
WHAT IS THE KELOID EXCISION PROCEDURE?
Excision is performed under local anesthesia. The procedure is performed on an outpatient basis and requires minimal after care. If you decide to have Radiation Therapy, you must schedule a consultation with a Radiation Doctor who will discuss all the risks, benefits and alternatives of Radiation Therapy. Our offices will refer you to a specialist in this area. After consulting with the Dr., you can schedule the surgery for Keloid excision and coordinate times so that your first Radiation treatment is on the same day as the excision. Thereafter, you will need one to three more radiation treatments according to Dr.’s recommendation. The stitches are removed between the 5th and 6th day. |
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Oleh Slupchynskyj, MD
Aesthetic Facial Plastic Surgery Center of New York
44 East 65th Street
New York, NY 10065
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