Fibrous skin tumours typically occur when the skin is damaged and is more common among individuals with relatively darker skin. The non-cancerous tumour is known to affect males and females equally without distinction. The appearance of marks or scars on visible parts of the body are typically treated through one of many options. While many individuals live with the scars unaffected, many look at remedial options due to the nature of their work/profession. We will take detailed look at what causes keloids and how the scars can be managed effectively. While it may not be possible at times to fully clear the scarring, it is possible to use combination of methods to conceal it effectively.

What causes keloids and is it permanent in nature?

As briefly mentioned above, keloids form on the skin when the skin is damaged due to either cuts, acne, vaccination, chicken pox and surgery. Individuals who have suffered insect bites are also known to end up with keloids. Similarly, tattoos and piercings are also known to cause keloids. When answering the question what causes keloids it is important to note that the possibility of developing the tumours is unrelated to the nature of the wound. For instance, even minor wounds can trigger the formation of keloids. Keloids are permanent in nature once the scarring has formed. While the growth of the scar may actually stop after a particular period, the scar is permanent unless it is removed.

Do all wounds cause keloid formation?

The straight answer to the above question is no – not all of the wounds end up with keloid formation. Wounds that do not heal properly result in keloid formation. To explain this further, the fibres of the skin comprise proteins called collagen and the production of collagen and its breakdown is a well-regulated and balanced process. Keloid formation is attributed to the excessive formation of collagen as a result of the response from the fibroblast cells in the skin. This excessive production of collagen causes the formation of scars. In addition to excessive production, the collagen that is produces is also thicker in nature, and consequently, the scarring appears raised from the adjacent areas of the skin.

While there are no conclusive reasons for this slightly abnormal healing process that results in scarring, it is attributed to genetics, and the possible presence of more fibroblast cells, which trigger the response. It is also possible that the different skin tension could be responsible for this response of the fibroblast cells.

How to identify keloids?

While the answer to the question what causes keloids gives an idea about the reason, it is also necessary to identify keloids so that it can be handled appropriately. The coloration of keloids could vary from dark to a lighter shade – pink. The scars are always raised in nature and will grow over a period of time, before finally stopping. Individuals with keloids may find it irritable and painful when clothes rub against the scars. Additionally, when the scars are exposed to the sun, the color is likely to turn darker and this darkened color will remain permanent on the scar. Here are the four different characteristics that will help you identify the formation of keloids :

Growth of keloids: Contrary to perceptions, growth of keloids can take as much as 3 months. In other words you may not even know that keloids are forming until after three months. Additionally, the growth of keloids can continue for a long period.

Visible indications: Keloids may first appear as a slight scar that is raised from the surrounding surface of the skin. The scar may be light in color and start darkening as the scar develops, and over a period of time, the scar will eventually appear darker than the surrounding skin.

The feel of keloids: The feel of keloids are different to the touch. Depending on the place of keloid formation, some may be hard to the touch while some may be soft.

Tenderness and itching: When the keloids are growing, the raised scar may probably itch and could be tender. However, it is not necessary for all keloids to itch and have a tender feeling. The itching sensation and tenderness of keloids are present only when the keloids are growing and will stop once the growing stops.

In addition to learning about what causes keloids it is also necessary to know that once the keloids stop growing, it remains stable. However, if the site of the keloids is injured again, there is the possibility of new keloids growing at the site.

How to prevent the formation of keloids?

Now that we have a fair idea of what causes keloids it is necessary to understand how to prevent the formation of keloids. Simple preventive methods help in reducing the possibility of keloid formation. For instance, individuals who avoid tattoos, or body piercings reduce the possibility of keloid formation. Similarly, surgery that is unwanted needs to be avoided as this could cause keloids. In the even that minor surgical procedures are unavoidable, it is necessary to commence treatment of the scars immediately. This will help to bring down the possibility of scarring and improve the rate of healing of the wound. Consequently, the possibility of scarring will also reduce.

Practice better wound management techniques – It is essential to practice better wound management techniques. For instance, it is advisable to cover new wounds with petroleum jelly and to hold this down with a bandage. The bandage needs to be of the non-stick variety and this needs to be pressed down evenly with another layer of tape to ensure that the pressure on the wound is distributed evenly. The wound needs to be properly cleaned at periodic intervals. After the wound has healed, it is advisable to use a silicone gel bandage to maintain distributed pressure on the wound. This will, in turn help to prevent the formation of keloids. Most individuals tend to discard or stop the use of bandages after a short period. However, the use of silicone gel bandages for atleast half a day for around two months will help to prevent the formation of keloids. Women who opt for ear piercings are advised to use pressure earrings as this will also prevent the formation of keloids.

Typical methods for managing the scars

Now that we have understood what causes keloids let us look at common methods for managing the scars. Keloids can only be managed and not treated. In other words, you can resort to methods to ensure that the keloids are less visible, but you cannot remove it completely. In certain instances, keloids are known to grow back after a particular period.

This is common in bite related keloid formation. It is sometimes necessary to use more than a single method to handle the condition for best results. Some of the commonly used methods include cryotherapy, where the keloids are frozen, and this is generally chosen when the size of the keloids are small. Typically, this method is used when the scars are attributed to acne, and this method is also known alter the color of the skin.

Another popular method of managing keloids is to inject the raised scar with corticosteroids. This method is either used alone or in combination with cryotherapy. In addition to corticosteroids, other medications are also injected at the site to bring down the size of the scar. As can be seen from the reasons mentioned above about what causes keloids, the scarring is raised. This makes surgical methods one of the most effective for keloids that are large in size. However, the downside is the possibility of removal resulting in the formation of other keloids. Therefore, surgical methods are often used in combination with other methods such as lasers and injectibles. The last resort for treating keloids is radiation therapy. The risks associated with this method is the possibility of cancer.

With a better understanding of what causes keloids it is easy to understand that certain methods will help prevent the formation of keloids to some extent. In other words, you can keep the scarring at relatively moderate levels. For instance, the use of compression bandages for a period of around six months will help to keep the size of the keloid smaller. This can then be managed cosmetically to cover the scarring. Individuals who choose ear piercings are also at risk of experiencing keloid formation at the site of the piercing. To prevent the keloids from growing to a large size, the use of ‘Zimmer’ splints are recommended. These splints resemble earrings and help to reduce the size of keloids by as much as half.

New methods of keloid removal include laser therapy. This is effectively an advanced form of conventional surgery and offers the same benefits as that of conventional surgery. The approach to the surgery is different, but for all other practical purposes, it is more of an advanced alternative to conventional surgery. This means that the possibility of the scars returning after a period of time are the same for both forms of surgery.


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