Keloidosis: causes of development and methods of treatment

The photo shows typical growths at the site of the postoperative scar, which are called keloidosis. On the upper and lower edges of the scar, it is clearly seen that the red-pink tissue protrudes not only above the surface of the scar upwards, but also to the sides. In the center, the scar is clearly hypertrophied, but the edges are relatively even, not tense, and do not grow to the sides. This is a characteristic difference between hypertrophic and keloid scars.

A feature of the treatment of keloid scars is that the wrong tactics can aggravate the situation or give a recurrence of scar tissue growth. The basis of the keloid scar – proliferation of connective tissue, namely – knots of collagen fibers of varying degrees of maturity. Keloid occurs most often after surgery or injuries, when the intersection of the skin tension lines was made not along, but across them. Thermal and chemical burns, inflammatory processes, endocrinological imbalance, reduced immunity can also be the cause of the formation of keloidosis. Clinically, keloid growth is accompanied by itching, numbness, emotional discomfort, may spontaneously regress or resume after 6-12 months.

There may be several predisposing factors for scar formation. In this case, we can say with confidence about the young age – 10-30 years, it is at this age that the highest frequency of keloid formation is. Genetic predisposition, stress and hormonal surge also play a role in etiology.

Treatment of keloidosis:

1. Surgical excision of hypertrophic scar tissue. Complexity of the – high probability of recurrence of keloidosis up to 80-90%.
2. Compression of the scar formation site for 10-12 hours a day for 6 months, which has several effects: mechanically inhibits the growth of the scar due to impaired blood supply to the tissues.
3. Laser therapy: ablative laser therapy is aimed at sclerotizing the vessels that feed the scar.
4. Corticosteroids: Injections of corticosteroids directly into the scar inhibit collagen synthesis by fibroblasts and increase levels of collagenase, a natural enzyme that breaks down collagen.
5. Cryodestruction has a direct destructive effect on cells at the site of scar growth, and also disrupts tissue nutrition at the microcirculatory level.
6. Application therapy: application of special ointments (Contractubex, Aldara, Scarguard, Cordran, Cleofibrase). Silicone ointments and gels have their place in the treatment of keloidosis due to the hydration of scar tissues, which leads to their oxygen starvation and compression.

Dynamics of scar treatment