Keloids

Keloids or keloid cicatrixes – the abnormal growth of cicatricial fabric in the field of an injury, a burn, an operative measure, infectious damage of skin or other disturbances of its integrity considerably exceeding the sizes of primary injury. Localization of keloids is various. Most often keloids are formed in a zone of a thorax and shoulders, in the field of an ear lobe, on functionally low-active sites of skin. Severity of an injury does not influence probability of emergence of a keloid, its sizes. Externally keloids have an appearance of the dense tumorous education towering over skin on the 5-8th, faintly or brightly pink, cyanotic color. The etiology of keloids still remains to the unknown.

Keloids do not pose hazard to life and health of the person, however bring notable physical and psychological discomfort (not esthetic outward of a keloid). Formation of keloids is followed by the following symptoms:

• Itch when combing;
• Pain when pressing;
• Increase in sensitivity of the struck fabrics;
• Redness in the field of a keloid.

Distinguish two stages of development of keloids:

• The active stage is characterized by the dynamic growth of a keloid that brings physical discomfort to the patient (morbidity, an itch, numbness of the struck fabrics), at this stage it is accepted to speak about an active keloid;
• The inactive stage is characterized by full completion of formation of a keloid, the hem does not deliver to the patient of special discomfort. Such keloid is called inactive or stabilized, its color approaches natural skin color.

The keloid begins to form 1-3 months later from the moment of wound epithelization. The active stage of growth can last more than 12 months. Usually the keloid keeps a dense consistence and does not decrease in sizes.

It is necessary to distinguish keloids and hypertrophied hems as the type of a hem will define further tactics of treatment. The hypertrophied hem unlike a keloid is formed only in the place of injury of skin, does not exceed injury borders. Inflammations in the course of healing, accession of consecutive infection, endocrine dysfunction, decrease in local immunity are origins of a hypertrophied hem. Other signs are similar to a keloid.

At emergence of the following symptoms it is necessary to see a doctor:

• Strengthening of painful feelings as at mechanical influence (pressing, friction of a hem), and in a condition of its relative tranquility;
• Emergence of signs of an inflammation both hem, and adjacent sites of skin;
• Essential increase in a keloid for rather short period.

Risk factors of development of keloids

The exact reasons of formation of keloids are still unknown. There are factors substantially increasing risk of formation of keloids at the person from which distinguish:

• Genetic predisposition;
• The expressed xanthopathy;
• Certain localization of traumatic injuries of skin (thorax, ear lobe, area of a deltoid muscle);
• Infection of a wound in the course of healing;
• Imbalance of immune system;
• Hormonal imbalance in an organism;
• Age changes;
• Disturbance of an innervation.

Keloids on ears: etiology

Keloids most often strike an ear lobe. The puncture of a lobe of an ear or cartilage, carrying the ear rings made of the low-quality alloys irritating ear skin becomes one of the reasons of formation of keloids on ears. Keloids on ears deliver not only esthetic discomfort (a keloid arrangement in a visible place, impossibility to wear jewelry), but also physical as during an active stage of growth the keloid can cause burning sensations, an itch, the pains amplifying at mechanical impact on area (a hem zadevaniye in the course of clothing, during sleep). There is an assumption that the ear lobe puncture the gun and establishment of ear rings on screws promotes formation of keloids on ears. Now separate techniques of treatment of keloids on ears are developed.

Keloid: treatment, conservative techniques

Among ways of treatment of keloids distinguish conservative and radical techniques. Regardless of type of keloids, it is more preferable to begin treatment of a hem with conservative methods among which:

• Compression – use of pressure upon the area of skin struck with a keloid. Squeezing interferes with growth of a keloid, blocks its food, squeezes hem vessels that can lead to a stop of its growth;
• Use of silicone plates – the mechanism of influence of this technique of treatment of keloids is based on squeezing of capillaries, collagen synthesis reduction, reduction of delivery of mediators of an inflammation, hydration of a hem;
• Ointment therapy – this technique is additional and is seldom used as an independent type of therapy of keloids, treatment by ointments is based on auxiliary influence of the antibacterial, antiinflammatory, normalizing blood circulation substances;
• Corticosteroids – this technique is applied locally or by administration of substance in keloids, treatment of hems is based in this case on decrease in synthesis of collagen (oppression of division of the fibroblasts generating collagen, and also increase in concentration of a collagenase – the enzyme promoting collagen splitting);
• Cryolysis – damage of fabrics of a keloid, treatment is directed to destruction of cytoplasm and organellas of cells by a cryogen. This technique allows to remove a keloid completely. Advantage of this technique is the low probability of a recurrence of keloids;
• Cosmetic correction – various techniques (peelings, dermabrasion) directed to correction of outward of a hem.

Removal of keloids: aggressive techniques of treatment

Aggressive techniques of treatment of keloids assume hem fabric excision in the surgical way or a burning out of area of a hem the laser.

Surgical removal of keloids assumes removal not only fabrics of the hem, but also removal of the site of skin on which the keloid was formed. The main shortcomings of surgical removal of keloids is the high probability of formation of a new hem on site of surgical excision. Removal of the site of skin allows to reduce risk of formation of a new keloid. A recurrence during surgical removal of keloids reaches 74-90%. Surgical treatment of keloids is a necessary measure if conservative techniques of treatment of hems were ineffective.

Laser correction of a keloid allows to delete (to cut and cauterize) a hem with the minimum injury of surrounding fabrics. Laser correction is applied to complex treatment of keloids (it is combined with local and injection corticosteroid therapy). Unlike surgical excision the percent of a recurrence of keloids at laser correction is considerably reduced and reaches only 35-43%.

At keloids treatment by nonconventional means (traditional medicine), and also self-treatment can aggravate a situation.