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Keloid treatment

Updated: Jun 26


What is a keloid?

Keloids are a disease that occurs due to continued inflammation in the dermis, which is located deep within the skin. Since it is an inflammation, it causes itching and pain. Inflammation, which is normally necessary to heal wounds, continues excessively, causing blood vessels to form and appear red, and collagen fibers to form and swell. Therefore, it is a very unpleasant disease that causes not only pain and itching, but also the appearance.

Keloids are inflammation, so they are not tumors, and unlike malignant tumors, they do not metastasize or threaten your life, but they are very unpleasant, so it is important to treat them as a psychological malignant disease and treat them properly.

There is no need to worry too much, but the sooner you start treatment, the faster your recovery will be. NowEclar® plasterKeloids can now be fully cured by combining surgery, radiation therapy, etc.

Even if a patient thinks it is a keloid, it may actually be a burn ulcer, keloid, hypertrophic scar, mature scar, or scar contracture, and treatment methods differ for each. Regarding diagnosis, I think you need to go to the hospital.

Above all, keloids are often caused by physical constitution, and there are many cases where family members have similar symptoms. Keloids can also be caused by small scratches that you may not be aware of, such as acne or slight folliculitis, and they can appear as though they have suddenly appeared in a place where there is nothing else. They often appear on the chest, shoulders, arms (BCG injection sites), and abdomen (especially in the lower abdomen of those who have had a caesarean section). You may also develop a large lump in your pierced ear. It can also occur from shingles or jellyfish stings.

Risk factors for worsening keloids include the pulling force on the keloid area due to exercise (increasing inflammation), female hormones, pregnancy (worsening in late pregnancy and relieving during breastfeeding), and high blood pressure.


ear keloid

If the piercing becomes infected or the wound is slow to heal after getting the piercing, the possibility of this type of tumor developing increases. Using plastic surgery techniques, it is possible to remove the ear without changing its shape. Postoperatively, we will irradiate the area with electron beams and fix it with postoperative tape. In most cases, same-day surgery with local anesthesia is possible.


Keloid in the lower abdomen

After a Caesarean section or abdominal surgery, the scar that used to be a single line may spread laterally and become red and swollen. Larger keloids can be treated quickly with surgery and radiation therapy, while smaller ones can be treated with Eclar® plaster.


Keloid treatment

The optimal treatment for keloids varies depending on the location and various conditions.

Typical treatments are listed below.


☆Non-surgical method

〇Medicine

·Internal medicine

Oral medications include tranilast (Rizaben®) is said to be valid. This is an anti-allergic agent that suppresses the chemical messengers released by various inflammatory cells in the tissues of keloids and hypertrophic scars, suppressing the symptoms such as itching, and even calming down the lesions themselves. This is what is considered to be. Also,SaireitoChinese herbal medicine is also effective in alleviating symptoms.


・Painting

There are several things that are effective as ointments. For the purpose of suppressing inflammation,Dermovate®orAntebate®Linderon®steroid ointments and creams, non-steroidal anti-inflammatory drugs such as Staderm®, and heparin-like substances (Hildoid Soft®) There are moisturizers such as ointments, creams, lotions, and sprays. Additionally, mugwort lotion may be used to treat itching.


·Adhesive skin patch

The most commonly used drugs include steroid tape, an anti-inflammatory agent (with strong effects).Eclar® plasterOr, a weak effect can be obtained.Drenizon® Tape) and a sheet made of silicone gel (FSheet®, Cicacare®, Readycare®, Clinicel®, etc.), as well as polyethylene gel sheets (atofine®). By leaving the gel sheet on for a long period of time, it moisturizes and stabilizes the wound. Because the gel sheet itself has adhesive strength, it sticks perfectly to scars and keloids, and can be used repeatedly by washing. In addition, inexpensive surgical tape and rash-resistant silicone tape (Mepitac®) are also useful.


·injection

Steroids (such as Kenacort®) may be injected. Redness and swelling are significantly reduced. Like topicals, it is a steroid, so the disadvantage is that it may cause dilation of capillaries and thinning of the surrounding skin. Injecting into hard scars can be painful, and steroids can cause menstrual irregularities in women, so it is recommended that you get the injections from an experienced doctor at a specialized outpatient clinic.

The treatment of atopic dermatitis is often debated, and some patients have a negative reaction when they hear the word steroids, but if used appropriately, certain effects can be obtained. In the case of keloids, depending on the location, size, and various other conditions, it may or may not be better to use it. We consider steroid treatment to be one of many treatment options.


〇Quiet

For a long time, it has been thought that it is effective to immobilize burn scars with supports, bandages, chest straps, abdominal straps, knee braces, etc. Keloids and hypertrophic scars tend to form in areas that are constantly subjected to stress, so it is important to keep the scars at rest. Further compression can suppress excessive blood flow and improve inflammation at the wound site.


〇レーザー

Lasers may be used to treat keloids and hypertrophic scars. The main purpose of these treatments is to destroy blood vessels in keloids and hypertrophic scars, or to accelerate the breakdown of collagen.

At our keloid outpatient clinic, we have several types of lasers available, including dye lasers (Dye lasers) and Nd:YAG lasers, so you can try them out locally and continue using the lasers if they are effective. It can be irradiated. Additionally, fractional laser treatment can be performed on inflamed scars. However, treatment is not currently covered by health insurance.


〇Others

Various other treatments have been reported, such as treatment using liquid nitrogen, but currently there are few that are effective alone.


☆Surgery

If keloids are alleviated by the methods explained above, there is no need for surgery, but if they cause twitching (scar contracture) or become disfigured in noticeable areas If so, you should still undergo surgery.However, it has traditionally been said that these patients should not be operated on lightly. This is because if you cut it out into an oval shape and sew it back together, you'll end up with a slightly longer straight scar, but if a keloid or hypertrophic scar recurs from there, it will be bigger than before. Many doctors still think this way, but in plastic surgery, it is important to devise stitches to prevent recurrence as much as possible, and to incorporate radiotherapy methods such as electron beam therapy and brachytherapy. This solves these problems.

Although it is difficult to completely eliminate scars, it is possible to flatten them and reduce their redness by combining various treatments such as Eclar® plaster, surgery, and radiation therapy.The larger the keloid, the more difficult it is to treat. The sooner you start treatment, the faster your recovery will be.

〇Radiation treatment

Electron beam irradiation and brachytherapy are types of radiation therapy and are used to suppress angiogenesis, which is thought to be the cause of keloids. Of course, since it is radiation, it cannot be said that there is no statistical possibility of carcinogenesis, but in the 100 years or so of history of radiotherapy for keloids, there have been no reports that have clearly proven a causal relationship to carcinogenesis. . Please consult a radiation therapy specialist for safe treatment methods. Additionally, for very large keloids, radiation therapy may be performed without surgery.

*Please contact a specialized hospital for surgery or radiation treatment.


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