How to remove Keloids? - Picture, Symptoms, Causes and Treatment of Keloids

1. The cicatricial variety arising from previous injury, burns, bites, pydermas, acne or scars. An acne keloid is a specific entity in itself (see chapter 11).
2. Spontaneous. Some authorities doubt their spontaneous origin, and feel that primary wounds being very minute, escape notice. Trauma is caused, in such case, by mosquito bites, scratching, friction, pressure, bruising etc.

Certain races have an inherent predisposition to keloids, e.g., Negroes and Indians, and so also certain families and individuals. The sites of choice are the sternal region and the shoulders, though keloids can develop any where on the body.

Symptoms of Keloids

The lesion is elevated; there are claw-like projections from the edge of the lesion; its colour varies from flesh colour to pinky-red; the lesion has a firm consistency, a smooth, shiny surface and tendency to grow beyond the limits of the primary scar or injury (in this respect, it differs from a hypertrophic scar). After a certain degree of growth, a keloid becomes a stationary; it seldom undergoes spontaneous resorption. Keloids may be asymptomatic, but usually tend to produce itching and severe pain.

Prognosis of Keloids

Keloids are troublesome. The symptoms can be very annoying, even agonizing. The prognosis is good in small keloids, but bad in extensive or multiple ones because treatment in such cases is unsatisfactory.

Treatment for Keloids

PROPHYLACTIC. In susceptible individuals, every suspicious wound, burn etc. should be properly treated Wounds tending to heal by secondary intention should be grafted. Fresh loclized scars should be massaged with betamethasone ointment. Extensive scars need systemic corticosteroids. In the auther's opinion, it helps to prevent many keloids , and even abort early ones.

CURATIVE

1. Injection of hyaluronidase 600 to 1500 I.U. with 25 mg per ml of the intra-articular variety of soluble hydrocortisone or 10 to 40 mg triamcinolone. The mixture is injected into the keloid with dental syringe or dermojet; 1 to 5 ml may be required depending upon the size .Injections are given ones in 2-3 weeks for 3-5 times. Soft and early keloids may flatten while hard ones become soft and asymptomatic. Occulusive corticosteroid dressings are also beneficial.
2. Excision followed by X-ray therapy. Surgical excision alone, produces recurrence; hence radiotherapy should be commenced immediately. The dosage varies from 800 to 1200r. While the wound is healing, it should be dressed with betamethasone lotion or ointment.CO 2 Laser is very useful.
3. Tetra-hydroxy-quinone orally has been successfully tried in some cases of extensive keloids (Kelley and Pinkus). Thio-tepa 0.5% has been used topically after excision of the keloid wioth the success. Centella asiatica has been beneficially employed, orally, topically and intralesionally. Silicone gel or oil with compression bandage is very beneficial in contracting and flattening keloids. It is much cheaper and effective than silicone sheets.