Clinical Dermatology
Scars and Keloids
Scars and Keloids
Scars are visible marks that persist after healing a wound created after a trauma, a burn or a disease. After the wound closes completely, a gel is formed and the wound begins to produce collagen from the fibroblasts. This begins to create the new web that has a different colour and texture than normal skin. The redness created in a scar is not the ultimate scar, and to discard the scar or scar may take days, months, or years. What is attributed to scarring is the amount of collagen, and thus different types of scars are defined. There are different types of scars, but the most common ones are:
 
  • Scars that usually appear after burning and prevent motion, because the skin draws the underlying tissue during healing.
  • Hypertrophic scars that grow directly on the wound as thick clumps of scar tissue. They are affected and often red and may widen over time, but also change colour if hyper-pigmentation (darker color) or submucosa (lighter color) occurs.
In contrast, keloids are skin hyperplasias that grow with extracellular matrix and can occur at skin lesion sites. Keloids, in addition to aesthetic malformation and poor psychology that they can cause to patients, often have some troublesome symptoms, such as pain or itching. They are more common in women than men, and their appearance begins as a pink-coloured scar within one month of injury. In the coming months it takes the form of a hard, smooth plaque that often has an increased volume. Exactly this is the difference between keloids and hypertrophic scars. Keloids extend beyond the limits of the injury, whereas hypertrophic scars are limited to these limits. The most common places of keloids include the upper back and chest, shoulders, jaw, shin, ear lobes, and mainly occurr in young and teenagers while being more rare in the elderly and very young children.
Treatment of scars and keloids is a long-term and demanding process, as they can reappear.

At Dermatology & Cosmetics Lab, we recommend the following modern treatment techniques:
  • Endoscopic Cryosurgery: It is a safe, fast and painless method that is performed by local anesthesia. A specific cryoneedle enters the keloid, and supplies liquid nitrogen till the keloid freezes. The liquid nitrogen enters at the heart of the keloid, while in older treatments keloid cooling is carried out superficially by cryopreservation.
  • Cortisone Injections: It is a safe, fast and painless method that requires several repetitions until the results become visible. It is recommended for small-sized keloids that can be easily polished and improved in this way.
  • Fractional Laser: This is the most modern method of treating scarring. Fractional Laser remodels the deformed area of the keloid scar causing new collagen and elastin to develop. The results are visible and impressive after some sessions, and after each session, the patient can return unhindered to his daily routine.
  • Chemical peeling: Chemical peeling in which mainly trichloroacetic acid is used, creates a controlled "burn" to remove the outer layer of the epidermis and help to regenerate it.
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