Keloid scar (Colloid scar): photos, symptoms, therapy

A keloid scar (photo below) can appear in anyone. Abrasions after falls, burns from hot water or hot oil, cuts resulting from careless handling of sharp objects - all these problems haunt us throughout our lives. In most cases, injuries heal quickly without complications. But sometimes it happens that at the site of deep wounds, ugly scars form, which not only rise above the surface of the skin, but also grow on healthy tissue. Surgical excision, cosmetic techniques, and physiotherapy will help eliminate the defect.

What is a keloid scar (photo)

Keloid scars that occur after removal of a hemangioma or ear piercing, as in the photo below, represent an excessive spread of connective tissue in places where the integrity of the epidermis has been compromised. Such a defect looks unpleasant and can impair mobility when located next to facial muscles or joints. Currently, the exact reasons for the formation of keloid scars after cuts and other injuries are not known. Most experts believe that the pathology is associated with a disruption in the formation of connective tissue. The problem gets worse if germs get into the open wound. This leads to the fact that the size of the neoplasm exceeds the parameters of the wound.

According to the International Classification of Diseases (ICD-10), a keloid scar has the code L91.0. Plastic surgeon Brian Reedy

Visually, the disease stands out against the background of healthy skin and has a dark red or bluish color.

The boundaries of the formation are clearly defined, extending to the tissue far beyond the wound. It is fully formed within two years after its appearance. Keloids are diagnosed in approximately 4–22% of patients. The development of formation occurs not only in connection with damage to the skin, but also spontaneously.

The disease is observed in almost 90% of adolescents with acne. Plastic surgeon Naveen Singh

Usually scars are located on open areas of the body: face, chest, neck, shoulders. An aesthetic defect leads to the development of psychological problems and complexes. Colloidal scars lead to decreased self-esteem and psychosomatic disorders.

Why does a scar form?

Keloids are divided into two groups according to their formation:

Primary (spontaneous)

These scars appear on apparently healthy skin for no apparent reason.

The appearance of such keloids can result from:

• Hormonal imbalances;
• Internal injuries;
• Pregnancy;
• Chronic diseases.

Typically, scarring occurs on the neck, back, chin and jaw line, ears, especially the earlobes.

Secondary (false)

Such scars occur in areas of previously damaged skin due to any injuries, skin lesions and ulcers. Wound healing is often inhibited by infection, causing inflammation and scarring.

The reasons include the following:

• Unprofessional surgical intervention;
• Injuries, cuts and wounds healed without proper care and supervision of a specialist;
• Consequences of severe skin diseases, such as acne.

Predisposing factors (5 reasons)

Under certain conditions, the risk of developing keloid scars, as in the photo, increases significantly. Predisposing factors include:

• incorrect alignment of the edges of a fresh cut;
• suppuration of injuries, infection;
• strong tension of the skin surrounding the wound;
• hormonal imbalance;
• decreased immune defense of the body.

One of the reasons for the appearance of the disease is genetic predisposition. If the patient’s parents have had similar problems, then the likelihood of pathology occurring increases. Plastic surgeon Robert Tornambe

Research was carried out. One of them showed that perhaps people who have the AHNAK gene are more susceptible to developing keloids.

Rehabilitation calendar after blepharoplasty by day

• immediately after surgery

At the end of the operation, strips are glued to the eyelid area, and the patient is transferred to a ward, where ice is applied to the periorbital area to reduce swelling.

photo immediately after upper blepharoplasty surgery

As a rule, there is no pain after blepharoplasty. After 1-2 hours the patient is discharged for outpatient observation by a surgeon

• first day

On the first day after surgery, the patient is bandaged. On days 1-2-3, swelling begins to increase. It is necessary to make cold lotions with antiseptics.

• second day

On the 2nd day in the morning, you can take a single diuretic tablet (only as prescribed by your doctor) to reduce swelling. ъ

• the third day

Swelling on day 3 is usually maximum. You are allowed to shower and wash your hair.

• fourth day

On the 4th day, the swelling begins to gradually decrease, and the tension in the eyelids goes away.

• 5 day

During this period, the strips and stitches from the eyelids are removed.

• 6th day

After the stitches are removed, the strips are stuck on for a few more days.

• 7th day

By this time, the bruises are almost completely gone, the swelling is significantly reduced.

After a week, the most noticeable swelling in patients goes away, and you can already go to work, although it is optimal to stay at home for up to 2 weeks.

• 9th day

At this time the strips are completely removed

The swelling is significantly reduced. The suture line is reddish. You can start using cosmetics.

• 2 weeks

Even at this time, the redness begins to gradually decrease, the swelling continues to decrease.

• in three weeks

There is no longer any visible swelling and bruising, patients come to the clinic for routine dressing changes, and they can slowly resume light sports activities.

• a month later

You can return to full physical activity.

• 2, 3, 6 and 12 months

Scheduled control inspections are carried out. They assess the condition of the scars.

Signs of illness

External symptoms of a keloid scar (ICD-10, L91.0) are concentrated in the area of ​​any skin damage: burns, cuts, surgical sutures. The first changes are observed 2–3 weeks after the wound heals:

1. Subsequently, seals form in the affected area.
2. Pain occurs, skin sensitivity increases, and sometimes patients note itching and burning.
3. At the site of the scar, smooth compactions appear that are hard to the touch.
4. The skin acquires a reddish, bluish tint or turns pale.
5. Negative signs extend beyond the burn or cut.

In some cases, the growth of keloid scars on a finger or earlobe, as in the photo, does not stop for several years. As a result, skin growths in the form of tubercles are formed. Neoplasms can form on any part of the face and body.

The appearance of a keloid

There are three stages before the complete formation of a keloid:

• During the first 7-10 days, a thin epithelial layer appears on the affected area of ​​the skin, which may be accompanied by painful sensations;
• Next, scarring occurs within 25-30 days, scar tissue protrudes above the main skin;
• After the formation of a scar in the affected area, the percentage of connective tissue increases, blood vessels disappear over time, and the scar becomes denser.

Treatment methods (5 options)

In most cases, the disease does not pose a serious danger to the human body, however, it negatively affects the appearance. Over time, formations can shrink, thin out and become almost invisible. Patients whose keloid scars are located on the face and open areas of the body are wondering how to remove the annoying defect. Today, surgical, cosmetological, and physiotherapeutic techniques are used for this.

Surgical excision

Surgical treatment involves excision of the formation followed by plastic surgery or without it. The advantages of the technique include:

• reduction in scar width;
• alignment of tissue relief in the affected area;
• extraction of foreign particles;
• moving the defect to a less noticeable area.

The procedure is performed under local anesthesia. Excision of a keloid scar (ICD-10, L91.0) on the hand, fingers and other parts of the body is performed using a laser or scalpel.

The doctor lifts the edges of the wound and performs vascular coagulation. The final stage is removal of the formation and suturing. To increase the effectiveness of the surgical method, it is necessary to strictly follow all the recommendations of specialists.

After removing the scar, a pressure bandage is applied to the wound for 24 hours to stop the bleeding. Plastic surgeon Charles Boyd

Throughout the entire rehabilitation period, it is necessary to protect the affected area from sunlight, any damage, and skin tension. The surgical method of getting rid of keloid scars is relevant in the presence of extensive hypertrophic lesions, for example, those obtained after burns.

Chemical peeling

The procedure is successfully used to treat keloid scars in Moscow, St. Petersburg and other large cities of Russia. Chemical peeling is used in the early stages of formation of formations. The most effective are superficial and median techniques. Course therapy includes two stages:

1. Preparation. Sessions are held once a week; a total of 2 to 4 procedures are required. In the process of work, lactic, glycolic, pyruvic, and salicylic acids are used.
2. Activation of recovery processes. At least 5 – 10 sessions will be required. The action of chemical peeling is aimed at stimulating natural physiological mechanisms and improving trophic processes in healthy tissues.

Medium peels help get rid of colloidal scars formed after removal of basal cell carcinoma, cuts, and abrasions. The procedure is carried out using trichloroacetic, ascorbic, and citric acid. As a result, not only exfoliation of the stratum corneum of the epidermis occurs, but also a deep stimulating effect on all layers of the skin. Scars can be treated with a tiny drop of 80-100% trichloroacetic acid [TCA] placed directly into the center with a toothpick.

This is an advanced technique called TCA CROSS (CROSS is an acronym for chemical reconstruction of skin scars). A high dose of TCA essentially damages the scar, which turns on collagen production. Dermatologist Estee Williams (New York)

Fractional photothermolysis

The essence of the technique is the effect of laser radiation on the skin. A precisely focused thin beam creates microdamages on the surface of the epidermis. Cells nearby are activated to repair the injury.

The operation must be performed by a qualified specialist who knows exactly how to correctly set the laser wavelength. The effectiveness and safety of the session depends on the depth and diameter of the impact. Plastic surgeon Sam Naficy

Laser correction

It is a targeted effect on the surface of the epidermis, to a depth of no more than 1 mm. Laser resurfacing of keloid scars, as evidenced by patient reviews, is highly effective. The technique stimulates natural tissue regeneration with the formation of new collagen fibers. Collagen is able to displace the connective tissue that makes up keloids. As a result, the skin texture is smoothed and the texture improves. The number of sessions is selected individually for each patient, the positive effect appears after a course of treatment.

The main rule of the rehabilitation period is the use of sunscreen for 3 weeks. Plastic surgeon Azita Majidi

Sometimes patients do not know which doctor treats keloid scars or who they can turn to for help. If you have such a problem, you should visit a dermatologist, venereologist or cosmetologist.

Physiotherapeutic techniques (3 options)

Physiotherapy is often used in the fight against colloidal scars. The most popular procedures include:

1. Phonophoresis. It is the introduction of medicinal compounds into the treatment area using ultrasonic influence. To eliminate defects, lidase is used, an enzyme that breaks down hyaluronic acid. The procedure leads to increased blood flow and a decrease in scar density.
2. Electrophoresis. It is carried out using lidase and other substances. Special gaskets are impregnated with suitable components, then electrodes are attached to each of them. The latter are placed on problem areas for a few minutes. The current discharges are small, so the patient will feel a slight tingling sensation.
3. Microcurrents. The action of the technique resembles electrophoresis. Mild current discharges gently affect the surface of the epidermis, as well as muscles, blood vessels, and deep layers. After a course of treatment, metabolic processes in tissues are activated, lymph and blood circulation improves.

Experts do not recommend self-therapy for colloid scars after various injuries or removal of the thyroid gland. In the photo you can see what such imperfections look like. Some physical procedures can increase the growth of connective tissue, so before signing up for a particular session, you should consult a doctor.

Medicines

Photo: laid-production.gq

Drug treatment of keloid scars

The drugs used for the treatment of keloid scars are divided into 2 groups:

• general purpose
• local application.

General medications

If the cause of keloid scars is a violation of the human hormonal system, then hormone therapy cannot be avoided. In case of disturbances in the secretion of sex hormones, women of childbearing age are prescribed: Cyane-35, Zhanine, and during menopause - hormone replacement agents, for example, Cyclo-Proginova, Angelique, Klimonorm. Men are prescribed Androkur.

If the functions of other endocrine glands are impaired, treatment is carried out with specific hormonal drugs.

It is also advisable to use complex vitamins and minerals to help mobilize and increase your own defenses.

Prescriptions for the selection and use of drugs are made only by a doctor.

Local preparations

The range of such drugs is wide: gels for keloid scars, creams, ointments on different bases. Here are the following groups:

• corticosteroids,
• enzyme preparations,
• immunomodulators,
• anti-inflammatory

Good results are achieved with correct, regular use under medical supervision.

Corticosteroids

Ointment for keloid scars is often hormonal based. Hydrocortisone ointment, the main active ingredient of which is a glucocorticosteroid, has an anti-allergenic effect, relieves swelling, inflammation and itching. Triamcinolone acetate is often administered directly into the scar, which helps reduce collagen synthesis and relieve inflammation.

Enzyme preparations

This group includes Lidaza, Ronidaza and the more modern Longidaza. Due to the hyaluronic acid and collagen included in the preparations, the uncontrolled proliferation of fibrous tissue cells and swelling are reduced.

Immunomodulators

Treatment with immunomodulators is a relatively new method. Interferon is used, which is injected along the suture line after removal of the keloid scar. The drug is able to prevent its re-formation.

Drugs with a pronounced anti-inflammatory effect - Contractubex and Kelofibrase. Kelofibraze is able to maintain water balance in the skin, due to which the cream softens and reduces keloid scars.

The most popular medication that softens keloid scars is Contractubex.

This drug consists of 3 active components that determine its therapeutic effect:

• onion extract contained in Contractubex determines anti-inflammatory, anti-allergenic and bactericidal effects,
• heparin prevents blood clots,
• allantoin heals wound surfaces, promotes tissue hydration, reduces itching and scratching.

All components, being synergists, provide maximum therapeutic effect.

The advantage of Contractubex is the absence of side effects and contraindications.

Question answer

During the first days after surgical treatment, there is a slight increase in body temperature. If the indicators increase significantly, swelling and noticeable pain appear at the site of scar excision, you should urgently consult a doctor.

It is recommended to go for laser resurfacing in autumn or winter, when sun activity is reduced. Otherwise, you may encounter pigmentation. This also applies to various peelings..

Unfortunately, traditional methods are powerless against scars. It is not always possible to remove them with medication, so various masks will definitely not help.

Home treatment

Time-tested folk remedies can be quite effective in preventing relapses and tumors.

Some folk remedies against keloids:

• Compresses and infusions of chamomile, geranium, St. John's wort, mint, yarrow, marshmallow root or larkspur, individually and in mixtures;
• Oils and extracts rich in vitamins, acids and antioxidants, for example, sea buckthorn, camphor, olive or melaleuca oil, known for its healing and healing properties;
• The well-known cabbage, in particular, crushed leaves of the plant with honey give a positive effect against colloidal scars.

Top 5 ointments for scars

The main active ingredient in medications for scars is allantoin. This substance helps retain moisture in the affected tissues, which accelerates regeneration and smoothing of the skin texture. The list of the most effective ointments includes:

• Contractubex . Reviews of this remedy for colloidal scars confirm its effectiveness. The action of the drug composition activates healing, blocks inflammation, softens the scar, and slows down the spread of connective tissue. The course of therapy takes 3–6 months.
• Dermatix . The main properties of the gel: improving the appearance of scars, maintaining moisture in the affected epidermis. The ointment softens and smoothes the affected areas, reduces itching, and restores healthy skin color. Treatment takes several months.
• Clearvin . Suitable for combating hyperpigmentation, post-acne, postpartum stretch marks. The Ayurvedic preparation has a natural composition, which includes aloe vera, turmeric, bhasma, beeswax and other components. The drug normalizes blood circulation, lightens scars by several tones, and evens out the skin.
• Kelofibrase. Suitable for treating scars left after dermatological diseases and surgery. The active ingredients are heparin and urea, which soften the epidermis, saturate the cells with moisture, and even out the relief.
• Zeraderm Ultra. The product is intended to eliminate fresh and old keloids. The ointment protects the affected area from UV rays, negative external factors, and stimulates the growth of healthy tissue.

Before buying the first drug you come across and smearing it on a colloidal scar, you need to consult a specialist. The listed remedies are considered the most effective, but they are all characterized by high costs, and treatment takes a long time.

Symptoms

What should you pay attention to if you suspect a colloid scar?

• Smooth and constant growth;
• Change in skin color;
• Pain with pressure;
• Termination of excretory processes and hair renewal;
• Localization in areas characteristic of keloids.

Reviews

ALINA, 25 YEARS OLD:

“After giving birth to my baby via caesarean section, I developed a colloidal scar on my uterus. The doctors said that the only way out of the situation was laparotomy or surgery. A blood transfusion is performed along with the intervention, since there is very heavy bleeding during the procedure. At the same time, I was prescribed antibacterial and antiviral medications. Rehabilitation took about six months.”

KLAUDIA, 33 YEARS OLD:

“My sad story began several years ago, after receiving a severe thermal burn. The main damage was to the arms and chest. After hospital treatment and wound healing, doctors performed a skin graft from the thigh. Everything took root, but terrible purple-blue scars appeared. I contacted several plastic surgeons, but received only refusals. On the Internet I read the story of one girl who treated keloid scars with Diprospan and posted before and after photos. I bought the drug and went to the clinic for injections once a month. In the first couple of weeks, my arms and chest itched mercilessly; after about a month, the itching decreased, the scars began to slowly and slowly fade and soften, and over time the size of the damage decreased by almost half. Today I stopped the course of treatment due to pregnancy, but after breastfeeding I plan to continue.”

Who is at risk?

Most often, true colloid scars occur in middle-aged people. False ones, in turn, can occur at any age as a result of past and chronic skin diseases, after severe burns, as well as in women during pregnancy due to very strong and uneven stretching of the rather delicate skin of the abdomen.

Expert opinion

• Cosmetologist
• Surgeon

Deborah Longwill

practicing dermatologist-cosmetologist

If symptoms of pathological proliferation of connective tissue are detected, it is prohibited to use aggressive means at your own discretion. Do not allow the affected area to become infected, do not visit baths, saunas, or take a hot bath.

Aisha Baron

plastic surgeon

In the presence of keloid scars, laser hair removal and massaging of formations are contraindicated.
It is not recommended to use traditional medicine methods; they will not bring a positive result. It is better to consult a doctor who will help remove the deficiency using professional methods. The appearance of keloid scars is an unpleasant problem, as it can negatively affect a person’s emotional state. But you should not put up with such a drawback, because today there are many ways to eliminate it. The main thing is to choose which one is right for you.