Dr Teja Kulkarni
Dr Teja Kulkarni
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Treatment of Keloids & Hypertrophic Scars
A keloid is a type of scar.  It is the result of an overgrowth of tissue at the site of a healed skin injury. A keloid is a firm, rubbery lesion or a shiny, fibrous nodule and can vary from pink to flesh-coloured or red to dark brown in colour. It can expand in claw-like growths over normal skin. It is benign, non-contagious and sometimes accompanied by itching, pain and changes in texture. Hypertrophic scars look similar, but do not grow beyond the boundaries of the original wound and stop growing after one year.  Also, these usually are not itchy or painful.
Locations of keloids: They are more common in some sites such as central chest, back and shoulders and the ear lobes but can also develop at places where abrasions or any other forms of injury have occurred. They can be the result of pimples, insect bites, scratching, burns, etc. They can even develop after surgery.
KeloidsHypertrophic Scars
KeloidsHypertrophic Scars
People of all ages may develop keloids.   However, children under 11 are less likely to develop keloids, even when they get their ears pierced. The tendency to get keloids may be hereditary.
Treatment: Keloids present a therapeutic challenge.  No treatment for keloids is considered to be 100% effective. The following treatments have varying degrees of success. 100% response is almost never seen but the scar can be made much less disfiguring.
Dr Teja Kulkarni Injections given into the keloid or hypertrophic scar — These are best used as the scar begins to thicken.  The earlier started the better.  They work, however, even if started late.  The action remains for about 3 weeks, when the next dose is given. A series of injections usually reduces the size of the scar and the symptoms, if any. The number of injections to be taken will depend on the size of the lesion, how early treatment is started, etc.  Individual response may vary.
Dr Teja Kulkarni Invasive methods - Surgery, laser ablation, cryotherapy, etc.  carry a risk of the keloid recurring (coming back) and becoming bigger than it previously was.  However, keloids are less likely to return if removal is combined with other treatments.  These methods may be used if the keloid is large, very unsightly, hampering movements, etc.
Dr Teja Kulkarni Compression - Compression bandages applied to the site over several months, sometimes for as long as six to twelve months, may lead to a reduction in the size of the keloid. Silicone Scar Sheets may be used safely under compression garments to aid in preventing new scars.
Dr Teja Kulkarni Gels and creams - There are numerous gels and creams on the market that may work if used long enough.  Some of these contain onion extract; some contain allantoin, silicone, etc.  Treatment is simple but requires persistence. The earlier the initiation of treatment, the better the results.
There is no ‘best’ method.  Treatment is individualized according to the site, size and the consistency of the scar.
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