MALAYSIAN SOCIETY OF PLASTIC RECONSTRUCTIVE SURGERY
DR FAIZAL ALI
Plastic,reconstructive AND COSMETIC Surgeon
Bilateral ear lobe keloid Before and one month After excision and triamcinolone injection
Keloids and Hypertrophic Scars
A hypertrophic scar and keloid are a skin conditions characterized by deposits of excessive amounts of collagen which gives rise
to a raised scar. They can form most often at the sites of pimples, body piercings, cuts and burns. They often contain nerves and blood vessels. They generally develop after thermal or traumatic injury that involves the deep layers of the dermis. Also
mechanical tension on a wound has been identified as a leading cause for hypertrophic scar formation.
When a normal wound heals, the body produces new collagen fibers at a rate which balances the breakdown of old collagen. Hypertrophic scars are red and thick and may be itchy or painful. They do not extend beyond the boundary of the original wound, but may continue to thicken for up to six months. They usually improve over the one or two years, but may cause distress due to their appearance or the intensity of the itching; they can also restrict movement if they are located close to a joint. The difference is that keloids tend to grow beyond the boundaries of the original wound and can be very disfiguring
especially if they affect the face.
Some people have an inherited tendency to this type of scarring. It is not possible to completely prevent hypertrophic scars, so those who have suffered from them should inform their doctor or surgeon if they need to have surgery. Scar therapies are available which may speed up the process of change from a hypertrophic scar to a flatter, paler one.
Treatments for hypertrophic scar and keloids include :
1. Emollients and moisturizers.
2. Silicone gel and sheets.
3. Regular massaging of the scars.
4. Intralesional injection of triamcinolone.
6. Fractional carbon dioxide and pulse dye lasers.