Keloid
Cosmetic Surgery - Plastic Surgery - Aesthetic Medicine - Reconstructive Surgery
A keloid is a hardened and branched fibrous swelling, formed on the
skin of a scar. keloids do not hurt most of the time, a keloid is
seldom very painful; occasionally they may be itchy but mostly they are
very sensitive to friction. Keloids do not occur indiscriminately in
everyone. They only affect certain individuals. There is not, at
present, any proof of the existence of a "keloidal diathesis ". Keloids
develop as a result of a wound caused by trauma or surgery. The keloid
develops as a result of a wound caused by trauma or by surgery. A
keloid may also be formed as a result of certain skin diseases (acne,
herpes zoster and folliculitis), simple scarification after vaccination
or during the healing of burns.
In aesthetic surgery, the risk of scarring is very significant, and if
good results are to be achieved, must be taken into account. For
similar patients, the risk varies from one patient to another. Some
subjects will produce the amount of tissue needed to produce fine and
soft healing. Others will produce scar tissue in abundance. In those
cases, the scar will thicken and swell, becoming bumpy (hypertrophic
scarring) A hypertrophic scar will evolve into a wide scar over about
18 months. A scar that persists beyond this period becomes a keloid.
The starting point of a keloid is the scar. First there appears a
projection which spreads along the scar and becomes easily
distinguishable because it overflows the scar area regularly or
radiates out in the form of «crayfish claws.” The edges of a keloid are
distinct, it has a smooth surface. Its colour starts as red and later
becomes pinkish or white. The size of keloids varies, they do not carry
on growing indefinitely but stop after a time. Keloids may regress but
only partially.
Keloids routinely recur, making their surgical removal very delicate.
The preventive effect of X-rays is used before and after surgery in a
patient with a tendency to develop keloids during healing. However,
X-ray treatment has no effect on keloids that are already formed.
Treatment of keloids by cryotherapy is long and painful, as is
treatment with injections of corticosteroids into the keloid.
For patients at risk, the qualified plastic surgeon will take all the
necessary precautions to prevent poor healing, such as avoiding certain
parts of the body, concealing and minimizing incisions and using the
finest suturing systems.