London skin expert puts the spotlight on keloid and hypertrophic scars

A lovely young woman smiling. Do you have scars that bother you? Speak to Sue Ibrahim at Elan Medical Skin Clinics in central London and Rayleigh, Essex

Do you have scars that bother you? Speak to Sue Ibrahim at Elan Medical Skin Clinics in central London and Rayleigh, Essex

Scarring of the skin can cause considerable upset and embarrassment. At Elan Medical Skin Clinics in central London and Rayleigh, Essex, our nurse consultant in dermatology, Sue Ibrahim, has more than 30 years’ experience in dealing with skin conditions. If you have a scar that causes you to feel unhappy and embarrassed about your appearance, please contact us today.

When a wound heals, it leaves a scar. A keloid is a special type of scar that grows too much and can even become larger than the original wound. Most people never get keloids and others get them after the most minor of injuries. Keloids look like exaggerated scars: they are raised above the skin around them and they are sometimes domed in shape.

Keloids are shiny and hairless and usually feel hard and rubbery. New ones are often red or purple, becoming darker or sometimes paler as they age. Most people with keloids have only one or two. However some people have many, especially if they have come up after acne or chickenpox scars.

Hypertrophic scars

It is not uncommon for surgical or injury scars to become a little lumpy and it is this characteristic that makes a scar hypertrophic. A keloid, which most commonly arise between the ages of 10 and 30, differs from hypertrophic scars in the following ways:

  • A keloid can come up after very minor skin damage, such as an acne spot, or even if there has been no obvious damage to the skin at all.
  • It can spread outside the original area of skin damage.
  • It may last permanently.

Treatment of keloid and hypertrophic scars

Keloids can be tender, painful, itchy, or cause a burning sensation. The main problem is that their appearance may cause embarrassment. If they are very tight, they can limit movement at nearby joints. At Elan Medical Skin Clinic we treat keloid and hypertrophic scars either by a course of intralesional steroid injections or surgical removal.

A steroid solution is injected into abnormal skin, with the aim of improving its appearance or reducing symptoms such as itch or pain. The steroid preparation most frequently used in this procedure is called triamcinolone acetonide, and you may hear the procedure referred to as “intralesional triamcinolone”. Injections of a steroid (triamcinolone) into a keloid may help to flatten small early ones.

Risk factors

  • Dark skinned people get keloids much more easily than those with a paler skin. They are especially common in people with black skin.
  • Keloids can crop up anywhere but do so most easily on certain areas, such as the skin around the upper chest and shoulders – particularly over the breastbone (sternum) – and on the earlobes.
  • Wounds that are under tension while healing, or which get infected, are particularly likely to form keloids, as are burn and acne scars.
  • Having previously had a keloid increases the risk of getting another if subjected to trauma to their skin.
  • Keloids are not contagious and have a very small risk of turning into skin cancers, which is more likely if they are treated with radiotherapy.

Thanks to the British Association of Dermatologists for information contained in this article.