Dear deblinv-ga;
Thank you for allowing me an opportunity to answer your interesting
question.
A very wonderful, life-long friend of mine, who sadly passed away
recently due to an unrelated problem, had developed a tendency to get
keloids early in his adult life. As with those who are most prone to
keloids (a more complicated form of “hypertrophic scarring”), he was
of black African descent. However, this condition does not exclusively
affect those of black African descent. While African-Americans are
considered to be at increased risk for developing keloids, person’s
with darker pigmented skin (Blacks, Orientals, Hispanics, Indians,
Arabs, etc.), and those whose biological heritage includes ancestors
with darker pigmented skin (whether they actually have dark skin
themselves or not) are also at greater risk of developing keloids than
Caucasians and other genetically lighter pigmented people. This is
especially true in the at risk population over the age of 30 or so.
Oddly enough, among Caucasians, this condition is more commonly found
among young, red-haired people and the elderly. The reasons for this
are not clearly understood.
David Larson, MD, Interim Chair of Plastic Surgery at the Medical
College of Wisconsin, explains what is known and describes the latest
treatments this way (and if you will forgive me, I must quote rather
than paraphrase since this pertains to medical treatment, for which I
am not a licensed professional):
“The most effective treatment is early diagnosis and injection with a
steroid solution. This will frequently slow down the scar production,
but not always. Another early treatment is the application of silicone
gel sheeting for at least 12 hours a day for a minimum of three
months. We don’t know why this works, but it is effective in about 1/3
of patients. Sometimes the sheeting is not practical to use, depending
upon the location of the scar. Pressure garments, or pressure earrings
for keloids of the earlobes, work well as an early treatment, but
their use must be continued for 8-12 months for full effect.”
“Sometimes the only treatment is to re-excise the scars, starting the
healing process all over again, and then institute some of the above
treatments earlier than could be done initially. On rare occasions a
short course of radiation therapy will control the scar formation, but
this treatment is reserved for particularly difficult cases and
carries some risk of its own! “
Quote obtained from: HEALTHLINK
http://healthlink.mcw.edu/article/996370237.html
Unfortunately, there is no single treatment for keloids, and most
treatments are unsatisfactory. All have variable success rates and
must be followed for at least a year. Two or more treatments, such as
surgical or laser removal followed by corticosteroid injections, may
be combined. Ironically, if you develop a keloid scar due to surgery,
one of the treatments is surgical removal. Since recurrence is also
common, this places you at even greater risk of recurrence but with
the added benefit of treating the scar much sooner the second time
around. If you decide to seek treatment for a keloid scar, you will
have better results if you start treatment soon after the keloid scar
appears. Available treatments include:
- Removal with conventional surgery — This unreliable technique
requires great care, as recurring keloids may be larger than the
original.
- Dressings made of silicone gel sheets.
- Compression — This involves continuous pressure applied 24 hours a
day for a period of months can have a thinning effect on the skin.
- Corticosteroid (triamcinolone acetonide) injections, repeated at
intervals of four to six weeks. This treatment may reduce keloid size
and irritation, but injections are uncomfortable.
- Cryosurgery — This freezing treatment with liquid nitrogen is
repeated every 20 to 30 days.
- Radiation therapy — This therapy is controversial because of the
safety risks.
- Laser therapy — This is an alternative to conventional surgery for
keloid removal.
Quoted from "American Academy of Dermatology"
Much more recently, “UV-A1” phototherapy (340-400 nm), which has
received a lot of attention as a possible means of treating other
dermal connective tissue related conditions such as atopic dermatitis,
morphea, and scleroderma, has prompted researchers to conduct studies
of its effectiveness on keloids scars. As you can see, initial results
are encouraging to say the least, but more work is yet to be done.
“We have demonstrated that UV-A1, even when given without psoralen,
can be helpful in the treatment of keloids. This finding is confirmed
histopathologically by the reappearance of normal-looking collagen and
elastic fibers within the keloid itself. If this treatment proves
effective in a larger-scale randomized controlled study, it will be of
great help to patients with large scars such as burn scars for whom
surgical remodelling or intralesional corticosteroid injection can be
difficult. It remains to be seen whether the combination of UV-A1 with
other treatment modalities (eg, intralesional injections of
corticosteroids or surgery) will offer further benefits and whether
the improvement observed with this treatment is permanent.”
Quote taken from: ARCHIVES OF DERMATOLOGY
http://archderm.ama-assn.org/issues/v135n3/ffull/dlt0399-2.html
From a report prepared by:
Pravit Asawanonda, MD
Lawrence S. W. Khoo, MD
Thomas B. Fitzpatrick, MD
Charles R. Taylor, MD
Department of Dermatology
Massachusetts General Hospital
55 Fruit St, BAR 410
Boston, MA 02114
Since keloids tend to become much darker (hyperpigmentation) than the
surrounding area when exposed to excessive UV rays, once a keloid has
developed, its physical appearance can be minimized to some degree by
avoiding excessive exposure to the sun on that area. Use of strong
sunblocker and UV creams or, in the case of smaller scars like those
that may appear on the ear or other area of a body piercing, Band-Aids
can often provide adequate protection in situations where you may not
otherwise be able to avoid excessive sunlight. There are also a number
of creams, salves, ointments, homeopathic treatments and herbal
remedies that claim to prevent, treat, reverse or remove keloids, but
many of these claims are unverified by the medical profession and walk
a fine line with other remedies that border on blatant quackery. If
you already know you are at risk of developing keloids, you should
discuss this with your surgeon.
Below you will find that I have carefully defined my search strategy
for you in the event that you need to search for more information. By
following the same type of searches that I did you may be able to
enhance the research I have provided even further. I hope you find
that that my research exceeds your expectations. If you have any
questions about my research please post a clarification request prior
to rating the answer. Otherwise, I welcome your rating and your final
comments and I look forward to working with you again in the near
future. Thank you for bringing your question to us.
Best regards;
Tutuzdad-ga
* INFORMATION SOURCES *
INTELIHEALTH: KELOIDS
http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/10218.html
THE IOWA CLINIC - KELOIDS
http://www.iowaclinic.com/adam/ENCY/ARTICLE/000849trt.shtml
HEALTHLINK
http://healthlink.mcw.edu/article/996370237.html
ARCHIVES OF DERMATOLOGY
(Caution: graphic images)
http://archderm.ama-assn.org/issues/v135n3/ffull/dlt0399-2.html
American Academy of Dermatology
930 North Meacham Rd.
Shaumburg, IL 60173
Phone: (847) 330-0230
Toll-Free: (888) 462-3376
http://www.aad.org/
Department of Dermatology
Massachusetts General Hospital
55 Fruit St, BAR 410
Boston, MA 02114
* SEARCH STRATEGY *
SEARCH ENGINE USED:
Google ://www.google.com
SEARCH TERMS USED:
Keloid prevention
Keloids “latest prevention”
Keloids medical report
Keloids research studies |
