Keloid Scars- Chicago Scar Revisions
A keloid scar
is a thick, puckered, itchy cluster of scar tissue that grows beyond the
edges of the wound or incision. They are often red or darker in color than the
surrounding skin. Keloids occur when the body continues to produce the tough,
fibrous protein known as collagen after a wound has healed.
This thick, over-grown cluster of scar tissue
on the earlobe is a keloid scar. Here it has been
removed and the incision closed with stitches,
leaving a thin scar.
Keloid scars can appear anywhere on the body, but they're most common over the
breastbone, on the earlobes, and on the shoulders. They occur more often in
dark-skinned people than in those who are fair. The tendency to develop keloids
lessens with age.
Keloids are often treated by injecting a steroid medication directly into the
scar tissue to reduce redness, itching, and burning. In some cases, this will
also shrink the scar.
If steroid treatment is inadequate, the scar tissue can be cut out and the wound
closed with one or more layers of stitches. This is generally an outpatient
procedure, performed under local anesthesia. You should be back at work in a day
or two, and the stitches will be removed in a few days. A skin graft (see the
section on skin grafting) is occasionally used, although the site from
which the graft was taken may then develop a keloid scar.
No matter what approach is taken, keloids have a stubborn tendency to recur,
sometimes even larger than before. To discourage this, the surgeon may combine
the scar removal with steroid injections, direct application of steroids during
surgery, or radiation therapy. Or you may be asked to wear a pressure garment
over the area for as long as a year. Even so, the keloid
scar may return, requiring
repeated procedures every few years.