Keloids are excessive scars that occur at the site of healing of damaged skin. This condition is characterized by excessive collagen formation, which leads to the formation of tumor-like, protruding formations on the surface of the skin, which can be characterized by itching, pain, and a cosmetic defect. Keloids can develop after various skin injuries, such as cuts, burns, surgical interventions, and even acne. Impaired healing processes and excessive formation of connective tissue are characteristic of this condition, but the exact mechanisms of its development are not fully understood. The disease is not infectious, but can significantly affect the patient's quality of life, increasing the risk of psychoemotional disorders.
History of the disease and interesting historical facts
Keloids have been known to mankind since ancient times. Archaeological research indicates that this disease was observed in people as early as Ancient Egypt, where it was described in medical texts. The description of keloids in the works of Hippocrates, who considered various types of skin scarring, is famous. In the Middle Ages, doctors used various methods of treating keloids, including the use of poultices and herbal infusions, but such approaches were rarely successful. In the 19th century, the problem of keloids began to be actively studied, and their removal by surgery was practiced. Over time, approaches to treatment and understanding of the disease have changed significantly. Progress in dermatology and surgery contributed to the creation of more effective methods of diagnosis and reduction of relapses.
Epidemiology
Statistics show that keloids develop in 5-15% of all people who have suffered skin trauma. People with dark skin, especially in African and Asian countries, are particularly susceptible to this condition. Although any touch to the skin can provoke the formation of keloids, some aesthetic procedures such as tattoos or piercings increase the risk of their occurrence. Gender differences in the prevalence of keloids are not so pronounced, however, the majority of cases are among young and middle-aged people. About 70% of all registered cases occur in people aged 15-30 years.
Genetic predisposition to this disease
Studies show that genetic predisposition plays an important role in the development of keloids. Scientists have identified several genes associated with this pathology, including COL1A1, COL3A1, and others, which are responsible for collagen synthesis. Mutated alleles of these genes affect the structure of collagen, which can lead to excessive formation of connective tissue during the healing process. People with a genetic predisposition have an increased risk of developing keloids, especially in response to skin trauma. An important factor is the transmission of these genetic features in families; for example, the presence of a keloid in a parent significantly increases the likelihood of its occurrence in offspring.
Risk factors for the development of this disease
Among the risk factors, the following can be distinguished:
- Skin type: People with dark or combination skin are at higher risk.
- Family history: Having keloids in close relatives increases the likelihood of their occurrence.
- Type of skin injury: Surgery, burns, acne or tattoos significantly increase the risk.
- Age: the disease predominates in adolescents and young adults.
- Hormonal changes: Increased hormone levels, especially during pregnancy or puberty.
In addition to the above factors, it is important to consider the emotional and stressful background, which can affect the skin healing process and, as a result, the likelihood of developing keloids.
Diagnosis of this disease
The main symptoms of keloids include:
- Protrusion above the skin level.
- A change in color, most often purple or red.
- Itching and pain in the affected area.
Various methods are used for diagnostics:
- Clinical examination: The doctor evaluates the appearance and symptoms.
- Lab tests: complete blood count and collagen level tests.
- Radiological examinations: in some cases, ultrasound or CT scans are used to evaluate internal tissue changes.
- Other types of diagnostics: dermatoscopy for a more detailed analysis of the skin structure.
- Differential diagnosis: it is necessary to exclude other skin pathologies, such as gigantoxis, erythematosis nodosum, and various dermatitis.
Treatment
Treatment of keloids can be divided into several categories:
- General treatment: In some cases, observation is recommended if the keloid does not cause discomfort.
- Pharmacological treatment: use of steroid ointments, injections of corticosteroids and dexamethasone.
- Surgical treatment: resection of keloids, which may lead to recurrence.
- Other types of treatment: cryotherapy, radiotherapy, laser technologies.
The main goal of therapy is to prevent relapses and minimize cosmetic defects. Each method should be discussed individually with a doctor, as the effectiveness and possible complications may vary.
List of medications used to treat this disease
The main medications used to treat keloids include:
- Corticosteroid ointments and injections (betamethasone, triamcinolone).
- Silicone gels and plates.
- Retinoids (tretinoin).
- Chemotherapeutic drugs (5-fluorouracil).
- Immunomodulators (tacrolimus).
These products help reduce scarring and prevent excess collagen production.
Disease monitoring
Monitoring of keloids includes regular monitoring of skin condition and evaluation of treatment effectiveness. The main control stages are:
- Visit a dermatologist on a regular basis.
- Evaluation of symptoms and possible changes in the condition of keloids.
- Analysis of relapse cases after treatment.
The prognosis of the disease largely depends on the methods of therapy used and the individual characteristics of the patient. Possible complications include recurrence of scars and deterioration of the aesthetic appearance.
Age-related features of the disease
The course of the disease has its own characteristics in different age groups. In adolescents and young people, keloids occur more often after injuries and often tend to grow. In older patients, the disease may manifest itself less often, but when it occurs, it requires more careful monitoring due to the increased risk of concomitant diseases. In children, keloids can also develop, which was associated with heredity and skin type. It is important to consider that at any age, the earlier treatment is started, the lower the risk of relapse and the more successful the result will be.
Questions and Answers
- What is a keloid? A keloid is an excessive scar that forms on the skin after an injury and may differ in size and color from the surrounding tissue.
- Who is at risk for developing keloids? Those at risk include people with dark skin and those with a family history of keloids.
- How are keloids diagnosed? Diagnosis is based on clinical examination and imaging techniques such as ultrasound when necessary.
- Is relapse possible after keloid treatment? Yes, relapses are possible, especially if the recommendations for care, hydration and injury prevention are not followed.
- How can keloids be treated? Treatment may include steroid injections, surgical resection, cryotherapy, and silicone gels.
Advice from Dr. Oleg Korzhikov
Dr. Oleg Korzhikov recommends the following approaches to the prevention and treatment of keloids:
- If injuries occur, you should immediately consult a doctor for timely treatment.
- The use of silicone gels and patches in the postoperative period can significantly reduce the likelihood of keloid formation.
- If you are predisposed, follow skin care recommendations to avoid further damage.
- Don't ignore cosmetic procedures; consulting a dermatologist will help reduce the risk of scarring.
- Discuss all treatment-related issues with your doctors to determine the best treatment options for your case.
In conclusion, keloids are a complex and multifactorial disease that requires a professional approach to diagnosis and treatment. Each case is unique, and it is important to consult a specialist for recommendations and effective assistance.
