Dear Readers:
L.L. is a 35-year-old female who lives in Spanish Town, St Catherine. Years ago, she was involved in a motor vehicle accident which caused numerous small cuts to her upper chest from a broken glass. Upon healing, many of these small lacerations left L.L. with several small raised scars to her chest, otherwise known as keloid.
Ugly scars
Some of these are still growing and L.L. asks Lifeline what can be done to treat these growths and prevent them from worsening. She says that the area above her breasts is really unattractive and she is unable to wear low-cut dresses or tops because of the ugly scars.
A keloid refers to a firm to hard excessive overgrowth of fibrous dermal tissue which may or may not be associated with a history of preceding trauma. They are thought to be the result of imperfect healing after some insult to the skin. This could be an insect bite, an abrasion, skin which has been itched, a laceration or no identified cause. An inadequate suboptimal supply of oxygen and nutrients to the injured area are usually blamed. Keloids can also occur in areas of skin affected by acne.
People of Black origin are more likely to develop keloid scars then any other ethnic group and the upper back, shoulders and chest are the most common sites. Acne keloid scars tend to occur after severe acne with abscess formation and the acne scars (keloiding) can be seen over the back of the neck and scalp and result in permanent hair loss to the affected area. Treatment may involve injecting the keloid scars with the steroid Triamcinolone at repeated intervals. This usually results in flattening and fading of the swellings with varying degrees of success.
Surgery
Surgery can also be employed to remove the keloid scar, followed by injection of the excised area with a steroid (usually triamconolone) to prevent re-scarring of the area. This procedure of re-excision with intralesional steroid injection is usually best left to the plastic surgeon or dermatologist.
When keloids result from acne long term treatment with antibiotics will help to prevent new scars.
Small doses of radiation (radiotherapy) to the area of skin following the excision of keloid scars has also been found to prevent recurrence.
The tendency for a keloid scar is to manifest itself as a family trait. If a person is known to be prone to developing keloid scars they should protect themselves when exposed to situations that might lead to a break occurring in the skin. The site of incision at any elective surgery would need to be discussed and properly planned.
L.L. should visit a dermatologist or plastic surgeon for review of her keloid scars, to determine the best treatment. She could attend the Dermatology Clinic at the regional hospital.
Write to:
Lifeline
P.O. Box 1731
Kgn 8
People of Black
origin are more
likely to develop keloid scars then any other ethnic group and the upper back, shoulders and chest are the most common sites