Keloids are elevated scars caused by excessive collagen in the dermis during connective tissue repair. Keloids are red elevated scars. They are often itchy and hard. These scars are not only found in places where skin trauma has occurred, but they cross the limits of the wound, spreading to the surrounding tissue. Unlike hypertrophic scars located on the wound itself, keloid scars can extend far beyond the edges of the injury, never resolving spontaneously. Keloids occur more often in women aged 20-30 years, and less frequently develop in children and older people. Most often they occur after surgical interventions, acne, cuts, inflammatory processes, chemical injuries, burns and piercings. It is assumed that due to genetic predisposition, some people are prone to the development of keloids even after minor injuries or without skin trauma.

Which regions are prone to keloids?

Skin areas prone to keloid formation are shoulders, chest, back, earlobes and chin especially in the jaw areas.

How do keloids manifest?

Keloids are caused by excessive collagen in the dermis during connective tissue repair, they always extend beyond the edges of the injury. They are irregularly shaped, feel hard, with shiny surface and without any hair. The colour of keloids is most often red, because of the formation of numerous new blood vessels. They can be painful or sensitive, with pronounced unpleasant itching. They never resolve spontaneously, and very often they have a tendency to recur after a treatment. People who are prone to keloids should not have surgical interventions performed on the predilected skin areas. Keloids pose a significant aesthetic problem.

How are keloids treated?

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Treating keloids is a medical and aesthetic challenge, precisely because of their unpredictable behavior. Also, there is a possibility of recurrence after a treatment. Treatment of keloids depends on their size and a previous response to therapy. The effects of topical therapy with corticosteroids, silicone gel sheeting, cryotherapy are very weak. In our practice, we use following methods with good results: * Intralesional corticosteroid injection consists of painless injection of corticosteroids into the scar itself. The medication is administered once a month and it can be repeated 3 to 4 times until satisfactory results are achieved. After the treatment, the keloid scar decreases, becomes softer, itching and soreness decrease as well. * VBeam Laser can be used for keloids, alone or in combination with corticosteroid injection. The laser closes numerous blood vessels, preventing the synthesis of collagen and facilitating its decomposition. After the Vbeam laser, the red colour of keloids disappears and the soreness decreases. Vbeam laser allows the remodelling of collagen in the dermis, softening the scar. This procedure can be performed at monthly intervals, and the number of treatments depends on the keloid age and colour. The best results are achieved when Vbeam laser is combined with Intralesional corticosteroid injection, stopping the further overgrowth of collagen tissue in the best way. * Surgical removal of keloids can be done if keloids did not respond to therapy. After a surgical intervention, i.e. after suture removal, it is necessary to inject corticosteroids to prevent the recurrence of keloids.
Svetlana Đurišić specijalista dermatovenerologije

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