Keloids

Keloids occur when wounds caused by skin trauma or inflammation heal abnormally. Keloidal scars may result from such factors as surgery, piercings, acne, tattooing, burns, abrasions, or lacerations. Although rare, keloids can manifest spontaneously as a result of taking certain types of medications or disease causing internal body inflammation. Keloids contain unusually high amounts of collagen and appear as firm rubbery nodules that extend beyond the site of trauma. It may take anywhere from 3 months to a year before they actually appear on the skin. While the keloid is growing, persons may experience tenderness, pain, itching, or burning; however, these symptoms typically subside once the keloid stops growing. People with darker skin tones develop this condition at a higher rate than their lighter skinned counterparts (American Academy of Dermatology Association, 2022; McGingty & Siddiqui, 2023).

Diagnosis

A physician’s examination of the scar is usually sufficient to diagnose keloids. Your doctor also may recommend a skin biopsy to rule out cancer.

Treatment

According to the Mayo Clinic (2023), several types of treatments are available to remove keloid scars including: a) pressure earring, dressings, or garments, b) injected medicines, c) laser treatment, and e) surgical removal.

Pressure earring, dressing, or garments

 Pressure devices are worn after a surgical procedure. They work by putting pressure on the wound as it heals so that it may reduce scarring. In order to be effective, they need to be worn daily from 4 to 6 months. 

Injected Medicines

A clinician may elect to shrink the keloids by injecting medications like cortisones into the scar tissue. Injectables are a long-term treatment that may take up to 6 months before the scar begins to shrink. Although this method is about 80% effective, it may produce side effects such hyper/hypopigmentation, skin thinning, and spider veins. 

Laser

A pulse dye laser is applied to the affected area for several sessions occurring in 4 to 8 week intervals. Side effects include hyper/hypopigmentation, crusting, and blistering.

Surgical Removal

If the keloids do not respond to any other treatment, a clinician may recommend to surgically remove the scar. However, this is not a permanent solution. Scars that have been cut out always grow back. Surgical removal is typically accompanied by one of the other treatments mentioned previously.

Living with Keloidal Scarring 

My advice to other people with visible differences is to never compare yourself to others. You’re unique, beautiful, and strong.” Bianca

What if all the treatment you sought didn’t work, or What if you decided not to seek any treatment at all. What if you decided to live with your keloid scars. The young lady photographed above uses her social media platform (@bianncahoneybeex) to showcase how she embraces her beauty while living with keloid scars. In the article Bianca's Story: "You can handle anything that life throws at you", she discusses how she developed into a confident woman, learning how to love and accept herself.

Like Bianca, many people with visible scars undergo a psychosocial evolution in the process of acceptance. How one perceives their visible differences not only impacts how the person feels about themselves but also how they interact with other people. When one develops scars, particularly in adolescence, he/she can experience a range of emotions including anger, sadness, and shame. Individuals with visible scars may experience self-doubt and wonder why this has happened to them. These feelings may cause individuals to anticipate rejection and withdraw socially, making it difficult to form meaningful connections with other people. Over time, one learns to cope with the psychological and emotional demands of visible differences. The journey to developing a healthy sense of self involves having a supportive social network and the belief that this scar is only a part of your story, not the story (Costeris, Petridou, & Ioannou, 2021; Ginsburg, 1996).

REFERENCES

American Academy of Dermatology +Association (2022, August 30) Keloid Scars: Signs and Symptoms. https://www.aad.org/public/diseases/a-z/keloids-symptoms

Costeris, C., Petridou, M., & Ioannou, Y. (2021). Psychological Impact of Skin Disorders on Patient’s Self Esteem and Perceived Social Support. Journal of Dermatology and Skin Science,   3(1), 14-22.

Ginsburg, I. H. (1996). The Psychosocial Impact of Skin Disease: An Overview. Dermatologic Clinics, 14 (3), 473-484.

Mayo Clinic (2023, July 13).  Keloid Scar.https://www.mayoclinic.org/diseases-conditions/keloid-scar/diagnosis-treatment/drc-20520902

McGinty S, Siddiqui WJ. Keloid. [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507899/