Pathological scars can be divided into three main groups: dehiscent scars, hypertrophic scars and keloid scars.
Let’s start by clarifying some basic concepts about keloid scars.
What is a keloid scar?
A keloid is a scar that responds abnormally, its fibroblasts continue to produce collagen without control even though the wound is already closed.
People usually call any wide or thick scar a keloid, however most of them correspond to hypertrophic scars or dehiscent scars.
What causes keloids?
Genetic, racial and body location factors are involved in the appearance of a keloid scar. Therefore, whether a scar evolves into a keloid does not depend on the surgical technique.
They are more frequent in black people, in families with a history of keloid scarring and in areas such as the décolleté, back and shoulders.
Sun protection is important to prevent further collagen formation and keloid pigmentation.
Is there a treatment?
The short answer would be “yes”, but it should be added that keloids respond poorly to treatments so it is advisable to combine different treatments and from early stages.
Types of treatment for keloid scars
In the treatment of keloids there is a scale:
- First step: Silicone gels, Silicone/polyurethane plasters. Improve scar formation, we usually apply them preventively. They help in the treatment of hypertrophic scars in early stages.
- Intralesional corticosteroids: They are injected into the keloid. It is effective in the early stages and if the keloid is not very severe.
- Vascular lasers + intralesional corticosteroids: Keloids are red-purple in color due to the number of blood vessels they have. The use of vascular lasers together with corticosteroid depot therapy offers good results.
- Radiotherapy: By means of Iridium rods. It would be the highest step and would be indicated in those keloids that have not improved with the above treatments, very symptomatic and with high functional and/or aesthetic repercussions.
Examples of different types of scars
From left to right (or from top to bottom on mobiles): keloid scar, hypertrophic scar and dehiscent scar.
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