A keloid scar is the result of an excessive increase in connective tissue that occurs at the site of skin fusion during the postoperative period.
Most doctors agree that the appearance of such scars is caused by a violation of the mechanism of connective tissue structure in the human body and excessive production of collagen.
Violation of the integrity of the skin is fraught with several types of scars:
Keloid scars arethe result of the growth of skin tissue over the surface of a healing wound, in which a tumor-like formation occurs on the skin.
A keloid scar is a smooth formation with a dense structure and evenly defined edges. The growth has a red, bluish or purple tint, which is explained by the growth of small capillaries into the skin. The boundaries of the keloid are located far beyond the edges of the wound itself and differ sharply from the surrounding tissue.
Keloid scars can interfere with movement. This is a particularly common problem when a formation occurs in the area of a joint or facial muscles.
The formation of a keloid scar is accompanied by pain. This may include tingling, burning, itching and occasional pain. The danger of such a growth is the high probability of relapse after treatment and the high ability to constantly grow.
What causes and how do keloid scars form on the body, head, face, ears
Keloid formation begins after the first restoration of the skin due to injury. At the site of a healed wound or cut, small compactions begin to appear, accompanied by discomfort. The seals increase, going beyond the scar, and acquire clear contours.
A keloid scar is finally formed within a period of several weeks to several months. The following factors are identified that increase the likelihood of their occurrence:
- hereditary predisposition;
- wound infection;
- unstable hormonal levels;
- incorrect alignment of the cut edges;
- strong skin tension in the cut area;
- pregnancy;
- insufficient wound care;
- problems with immunity.
The tumor occurs due to an imbalance in the production of collagen and elastin.
Normally, they are provided by fibroblast cells and lead to wound healing. When the border of the injured skin is violated, collagen fibers grow and cause the appearance of a scar.
Exposed areas of skin are considered the most vulnerable to the development of a keloid scar. This area is the ears, neck, chest, upper back, face and shoulders.
Scars after mole removal
A keloid can form at the site of mole removal as a result of disturbances in the functioning of the body and improper care of the injured area.
The place where the mole was previously located will become dense and a reddish tint will appear. Itching and burning may occur. At the first suspicion, you should contact a specialist.
Scars after rhinoplasty
Keloids after rhinoplasty are often the result of improper skin care. The nasal area is characterized by a tendency to develop inflammation. Having experienced stress from surgery, the skin often changes its type, and the sebaceous glands begin to work more actively.
To prevent scarring, you should follow your doctor’s recommendations and use antiseptics. It is worth noting that the risk of developing a keloid scar during repeated surgery is much higher. This is explained by the fact that the operation is performed on tissues that are initially injured.
Scars after blepharoplasty
Blepharoplasty is used to get rid of fine wrinkles, bags under the eyes and other cosmetic imperfections in the upper and lower eyelids. In this case, a keloid scar is one of the rare negative outcomes, since the procedure is performed with small incisions in the skin.
If you are prone to the appearance of keloids, your doctor will prescribe additional treatment. IN in this case It will be effective to apply a special silicone bandage to the injured area.
Scars after mammoplasty
A keloid scar is one of the possible disorders of skin healing after mammoplasty. Small stitches remain in any case, but during normal healing they become invisible.
To prevent the occurrence of keloid and proper tissue fusion, you should wear special compression garments for 6 weeks after surgery.
Scars after biorevitalization
Biorevitalization is considered one of the methods for treating certain types of scars.
Efficiency is achieved by performing biorevitalization in conjunction with laser procedures. Injections accompany tissue healing after laser resurfacing.
As a rejuvenating procedure, biorevitalization is contraindicated for people prone to the formation of keloids, since even a small violation of tissue integrity, but in large quantities, can cause scars.
Scars after piercing
The likelihood that skin healing will result in a keloid scar is quite high among piercing enthusiasts. This is due to genetic predisposition and improper care of the puncture site.
The growth of a keloid is also provoked by piercing jewelry, which creates additional tension. In addition, the earring creates friction against the skin, which also negatively affects healing.
If complications occur, it is recommended to remove the jewelry and undergo a course of restorative procedures. The areas most at risk are the nose, eyes and lips.
Scars after acne, pimples
Even an ordinary pimple can cause a keloid scar if there is a predisposition to it. People with dark skin are more likely to experience this problem. Acne marks increase in size and become keloids a month after initial healing.
They usually appear in large numbers but are small in size. The diameter of each keloid is on average 4 mm, but can increase over time.
Post-burn scars
As a result of the burn, a keloid scar can form. This is possible if there is a predisposition and the degree of skin damage is severe. A chemical or thermal burn leads to the formation of a keloid on any part of the body.
A scar can be recognized a month after the wound has healed, when single lumps begin to appear in the burn area. The likelihood of complications is higher if a large area of skin is affected.
How to remove keloid and hypertrophic scars after surgery. Laser removal. Reviews
The following methods are used to treat keloid scars:
To achieve a positive effect, the scar must enter the maturity stage and stop growing. To do this, the affected area is treated with hormonal drugs and ointments, as a result of which the scar loses color and becomes soft. Only ablative resurfacing that acts directly on the scar tissue is allowed.
Laser resurfacing “evaporates” the scar, making it less noticeable.
Patients note a decrease in keloid volume, loss of color and change in structure after the first procedure. During treatment, a tingling and burning sensation is felt, which is normal. If a large area is being treated, anesthesia should be used.
After laser treatment, the scar will require special care. The doctor will indicate the frequency of treatment with a disinfectant and healing cream. Chlorhexidine and Bepanthen are commonly used.
A few days after the procedure, the scar area will become covered with a crust that cannot be removed. Experts disagree about this method of treatment, since the laser can provoke a relapse.
Removal of keloid scars with liquid nitrogen – cryotherapy. Reviews
This treatment method is classified as a conservative type of scar correction. The procedure requires a nebulizer with liquid nitrogen, a cotton swab and an analgesic (if the scar is large).
Before resorting to the procedure, make sure that it is a keloid scar The advantage of removing the scar with nitrogen is that the risk of wound infection is reduced. Low temperature kills skin microflora, preventing infection. If infection does occur, this can be judged by swelling and the appearance of redness on the scar.
After exposure to nitrogen, a formation appears in the form of a bubble with liquid, which should not be pierced independently. Patients notice an improvement in the appearance of the skin, a change in the size and brightness of the keloid. However, the scar does not completely disappear.
To achieve the result, it is necessary to apply liquid nitrogen to the keloid scar for 2-10 minutes with breaks for thawing.
Treatment of keloid scars - drugs, ointments, creams. Photos before and after
Drug treatment is used both as an auxiliary or preparatory therapy before another type of treatment, and as the main method of treatment.
Ointments and creams basically contain collagen of different origins, which creates a film on the surface of the skin. The film prevents moisture loss, moisturizing the surface of the keloid. At the same time, hydration promotes healing and normalization of processes in tissues.
"Diprospan"
The drug is available in 2 forms:
- suspension;
- injection solution.
It is a hormonal agent.
To reduce the defect, the keloid scar is chipped once a month. This allows you to make it softer and reduce the brightness of the color. Doctors have differing opinions regarding the drug, since hormonal therapy can provoke changes in the body.
"Kontraktubex"
The action of the gel is ensured by the following components:
- allantoin– relieves itching and burning during healing, normalizes pigmentation, softens scars, and also activates blood circulation in the affected tissue;
- heparin sodium– makes the structure of the scar less dense, saturates the tissue with moisture and has an anti-inflammatory effect;
- cepalin(onion extract) – inhibits the development of fibroblasts, preventing the formation of a scar and its growth.
The gel should be applied 2-3 times a day, massaging the scar from the center to the edges. Treatment period is 3-6 months.
More positive feedback I received the drug for the treatment of acne marks. Patients were not able to significantly reduce their keloid size with this gel.
"Lidaza"
The drug “Lidaza” is based on hyaluronic acid, which fills cells and stimulates decay processes in scar tissue. In this case, there is no effect on the collagen-collagenase system.
Available in the forms of solution for internal use and powder for external use.
The drug does not show any visible positive results in the treatment of keloid scars.
"Solcoseryl"
"Solcoseryl" contains deproteinized dialysate from the blood of calves, which stimulates cell regeneration by supplying glucose and oxygen. The most popular forms of release are ointment and jelly. The concentration of the active substance in the jelly is higher.
When treating the scar 2 times a day for several months, improvements in the appearance of the skin are noted. But this remedy will not completely remove the keloid.
"Kenalog"
The keloid scar is almost completely removed with the drug "Kenalog". This is a drug that causes tissue atrophy. It is used as a course of injections at intervals of 1 month to six months. The full course of treatment depends on the age of the scar, its area and size.
As a result of using the product, the scar becomes flat and similar in color to the skin.
Patients who used this remedy noted a long-term positive effect.
"Dermatix"
Among the many remedies for scars, this drug stands out for its effectiveness. Available in the form of a gel and a gel-based bandage (fabric and silicone). It has a superficial effect due to the silicone in the composition, making the keloid scar flat.
This is one of the few products that act on the surface of the skin without changes in the inner layer. A significant disadvantage is the high price of the drug (about 1600 rubles).
The effectiveness of using ointments and creams increases when applied under a compressive bandage for several hours.
How to cure keloid scars at home - treatment with folk remedies
Traditional medicine recommends the following methods for removing keloid scars:
- compresses from infusions of chamomile, fennel, St. John's wort;
- massage with sea buckthorn oil;
- rubbing fresh honey;
- lubricating the surface of the keloid with rosemary and tea tree oil. These oils are essential oils, so they should be used in combination with a base oil;
- compress of crushed cabbage leaves and honey.
The effectiveness of these methods has not been proven. They can be used as an addition to the main therapy in consultation with the doctor.
How to hide a keloid scar - tattoo, permanent makeup
A keloid scar can be hidden with a tattoo or permanent makeup. These methods involve printing a long-term pattern directly onto the problem area of the skin, thereby masking the aesthetic defect.
Tattooing needs to be renewed periodically so that the scar is not noticeable in the future, and tattoos accompany a person for the rest of his life.
What is a keloid scar and how to get rid of it: video
What causes keloid scars and how to combat them - expert recommendations:
What is this, a keloid or hypertrophied scar? Doctor's explanation:
A keloid scar is an unpleasant cosmetic problem, the solution to which lies in comprehensive, competent treatment. The best result is achieved by a combination of active treatment methods (laser, cryotherapy, physiotherapy) and local effects medicines(ointments, creams and injections).
A keloid scar is a formation that forms on the skin at the site of injury. Provoking factors for its formation can be genetic predisposition and hormonal disorders in the body. Getting rid of a keloid scar is difficult and almost impossible. Well-known methods - ointments/creams, physiotherapy, laser resurfacing, injections into the scar, cryodestruction - only make it less noticeable, paler, softer and flatter.
Even surgical excision does not guarantee complete disappearance of the problem; there remains a high risk of the formation of a new keloid.
Read in this article
What is a keloid scar, types of formation
A keloid scar is a structure that forms in places where the skin is injured and is a connective tissue. In this case, it is immature; under a microscope, such a scar looks like bundles of irregularly shaped collagen. The peculiarity of this structure is the ability to spread to healthy, undamaged skin.
How does a keloid scar form?
- at the site of skin damage, a thin layer of squamous epithelium is formed;
- within 10 days this “coating” becomes rougher, becomes denser and acquires a bluish tint;
- over the next 20 days, the keloid grows, swells, and begins to protrude 3-7 mm above the surface of the skin;
- Gradually, the growth of the scar intensifies, its surface becomes covered with plaques, and this process stops only after one and a half to two years.
In medicine, two types of keloid scars are classified:
- young formations – formation began no more than 5 years ago, the process of growth of connective tissue has not yet stopped;
- old – scars were formed more than 5 years ago, do not grow, and have a pale and “lumpy” surface.
Reasons for appearance
The primary reason for the formation of a keloid scar is damage to the skin. But if there are no provoking factors, then the connective tissue does not cover the wound site and does not grow.
On the body
No doctor has yet named the exact reasons for the appearance of the formation in question, but most often keloid scars appear in people with hormonal disorders and a history of chronic infectious diseases (for example, tuberculosis). Additional provoking factors have been identified:
- incorrectly aligned wound edges during treatment, dressing or surgery;
- excessive skin tension at the wound site;
- decreased immunity;
- development of the inflammatory process and formation of purulent contents in the wound.
The factor of hereditary predisposition is separately considered - if there is a person in the family with regular formation of keloid scars, then his children and grandchildren may have the same problem (even simple scratches and abrasions will result in the appearance of a new formation on the body).
Keloid scar on the ear
A keloid scar on the ear often forms on the lobe after ear piercing or tearing of this part of the head organ. The provoking factors remain the same, but especially often the inflammatory process with suppuration of the wound is “triggered” - the place is extremely inconvenient for healing, there are certain difficulties with treating the wound.
The keloid may not stop growing for several years; it will continue to grow throughout healthy tissue.
Symptoms of formation
The formation of a keloid scar begins with damage to the skin, which can be of any size and depth of penetration. After some time (about 15 days), the victim notices the appearance of small lumps at the site of the already healed wound - they can be easily felt with your fingers. After a few more days, complaints of pain and a slight burning sensation at the site of injury begin to arrive; the skin in this area becomes too sensitive.
Further, the symptoms of keloid scars are so pronounced that no difficulties in diagnosis are foreseen - the tissue at the wound site begins to swell and rise above the general surface of the skin by several millimeters. There may be redness or paleness of the skin surrounding the injury site.
Keloid scars Most often, this type of formation is diagnosed on the neck, chest, ears and shoulders, extremely rarely on the face and in the area of the anatomical location of the joints.
Who gets scars more often?
According to statistics, keloid scars most often form at the age of 15-30 years. In earlier times, the skin has a high level of elasticity, so even the most complex wounds (for example, with torn edges) heal without any consequences. And after 30 years, the natural decline of all processes in the body, including regeneration, begins.
The incidence of the problem is the same in men and women.
Hypertrophic and keloid scars: what are the similarities and differences
Hypertrophic and keloid scars are visually similar in the early stages of formation, but doctors clearly separate these two pathological structures.
Hypertrophic |
Keloid |
only rises above the surface of the skin |
in addition to the formation of a lump, there is a growth of the pathological structure onto healthy tissue |
manifests itself only in appearance, does not cause discomfort or unpleasant sensations |
In addition to the appearance, the patient is concerned about burning, itching, pain at the site of formation |
becomes flat and pale over time |
appearance does not change over the years, the shade is bluish or reddish due to the growth of blood vessels into the keloid |
If we talk about differences at the microscopic level, experts note that the formation in question contains 8 times more collagen than with hypertrophic changes.
What is keloid disease
Keloid disease is a condition in which such formations form in a person even after microscopic damage to the skin. In this case, they speak of a predisposition to the formation of keloid tissue. Often the disease is diagnosed in people of the black race, but some scientists argue that genetic predisposition is “triggered.”
With keloid disease, scars form in the most unexpected places - inner side hips, area around the lips, inner elbow.
Possible complications from formation on the body
Keloid scars do not disrupt a person’s usual rhythm of life, do not worsen his health, and do not provoke the development of internal pathologies. But one nuance must be taken into account - they can grow to truly gigantic sizes, covering almost the entire body or face. The aesthetic side of the issue should not be ignored: such scars do not decorate and can lead to depression, psycho-emotional disorders, and the development of complexes.
The older the scars, the more difficult it is to remove them; in some cases, only surgery helps.
What to do if a keloid scar hurts
If a keloid scar hurts, doctors recommend using ointments and creams for external application containing anesthetics. Most often, such preparations contain lidocaine; they are applied directly to the sore spot and also affect healthy skin around the lesion.
The most accessible and effective means Lidocaine ointment 5% is considered. The instructions indicate that the product is used for local anesthesia, so you should not count on a long-term effect and gradual relief from pain.
Pain in a keloid scar can be relieved with non-steroidal anti-inflammatory drugs, but they are prescribed by a doctor.
Expert opinion
Tatyana Somoilova
Cosmetology expert
Overly impressionable people with increased sensitivity “invent” pain for themselves, in which case doctors talk about neuropathic pain syndrome. Psychotherapists can remove it, drug treatment not required.
How to remove keloid scars after surgery
Keloid scars after surgery must be removed immediately after their formation, in which case a set of therapeutic measures will be applied:
Only in this case will it be possible to do without long-term therapy, injections and surgery. As a rule, postoperative scars are diagnosed immediately, even before the patient is finally discharged from the hospital - a doctor who examines the patient daily will notice the pathological growth of connective tissue and prescribe medications.
The suture after surgery can become inflamed and suppurate, which are provoking factors for the formation of keloid, so doctors insist on eliminating any chronic infectious foci in the body, even if they are in a long stage of remission. We are talking about the sanitation of the oral cavity (cure caries), the treatment of tonsillitis.
How to get rid of a keloid scar during its formation
To get rid of a keloid scar, you should resort to a complex therapeutic effect on it - injections with the drugs Rodidaza, Lidaza, physiotherapy (cryotherapy, compression, laser therapy, ultrasound), you can try traditional methods (apple cider vinegar, lemon juice, aspirin), creams (the most effective - Contractubex, Dermatix, Kelofibraza).
The drug Diprospan has received conflicting reviews from doctors; many experts do not recommend its use.
Injections for keloid scars
Injections for keloid scars are performed directly into the pathological focus. The basis of injection therapy against scars is drugs with enzymes that break down hyaluronic acid(it just ensures the density of the scar). These include the drugs Rodidaza, Lidaza. The course of therapy consists of an average of 12 injections.
Before and after scar treatment with Lidaza You can stop the process of proliferation of connective tissue with Interferon, a drug that significantly improves and strengthens the local immune system. After the injections, she begins to actively fight the growth of the pathological focus. Injections are performed daily for 2 weeks, then switch to a schedule of 1 injection every 7 days. The general course lasts at least 70 days.
Drugs from the category of corticosteroids also provide the desired effect; they correct the process of collagen production. Injections are performed once every 4-6 weeks, the number of injections is determined by the doctor. Corticosteroid drugs have a long list of contraindications and serious side effects, so they are prescribed to only a few.
Physiotherapy
Physiotherapeutic methods are not the most effective in the fight against keloid scars, but they act as adjuvant therapy:
- Cryotherapy– applications with liquid nitrogen are applied to the pathological focus. The duration of the procedure is a maximum of 15 seconds, during which time the scar cells die.
- Squeezing– applying a pressure bandage to a young keloid scar, thereby stopping the growth of connective tissue. The bandage is worn for 9-12 months.
- Laser therapy– the beam “glues” the blood vessels and the formation simply dies without nutrition. It only helps on young keloid scars; at the same time, doctors prescribe hormone therapy, because the risk of relapse is high.
- Ultrasound– a bandage with ointment or gel is applied to the pathological focus, the active ingredients of which are natural enzymes. Then the scar is treated with electrophoresis or phonophoresis.
Treatment of keloid scars with traditional methods
Treatment of keloid scars according to folk recipes is also considered an auxiliary method and is appropriate only when solving the problem of a young appearance; you can use:
- Apple cider vinegar. It is rubbed into the surface of the scar 2 times daily (morning and evening). The general course of treatment is 4 weeks, the result will be lightening of keloid tissues.
- Lemon juice. It is rubbed into the problem area and left for 20 minutes, after which it is washed off with warm water. The procedure is performed daily (1 time) for 2-3 months.
- Aspirin. You need to turn 4 tablets into powder and dilute with warm water in such a proportion that the “output” is a creamy mass. It is rubbed into the keloid tissue, and after drying, washed off with warm water. The procedure is carried out 2 times a day for 30 days.
These methods make scars less noticeable and softer. You cannot undertake such treatment on your own; first you need to make sure that it is keloid tissue that has formed and that there are no allergies to the products included in the recipes folk remedies.
What ointments will help
Therapy with ointments is carried out for six months and is not always effective, but it speeds up the process of solving the problem against the background of physiotherapy and injections. The most effective external remedies are:
Dermatix |
Apply a thin layer to the lesion, wait 5 minutes for the cream to be absorbed. The procedure is carried out 2 times a day, the skin must be washed and completely dried before application. The course of treatment is 30 days, after which you need to pay attention to the condition of the scar - the lack of positive dynamics indicates the need to seek qualified medical help. |
Will Diprospan work?
Diprospan is a hormonal drug that is often used to reduce keloid scars. But doctors do not recommend such treatment:
- hormonal drugs have many contraindications;
- against the background of long-term use of the drug, disturbances in the functioning of the endocrine system occur;
- the scar does not disappear, but only becomes paler, softer and not so convex.
Watch this video about the treatment of keloid scars with Diprospan injections:
Methods for removing old and rough scars
Old keloid formations are difficult to treat - local medications, injections, physiotherapy and folk remedies will not give positive results. Doctors offer patients more aggressive methods.
Resurfacing of a keloid scar
A safe and painless method of solving the problem is resurfacing the keloid scar, which is carried out with a laser beam. For this, an erbium laser is used (impacts the upper layers of pathological growth) and a neodymium laser (“works” at a depth of 8 mm). To obtain the desired result, you will need to undergo at least 5 sessions, but the keloid will not be completely eliminated.
The result of resurfacing with a laser beam will be the separation of the scar, its softening, and paleness.
Before and after resurfacing a keloid scar Cryodestruction
Keloid tissue contains a lot of water, and if the lesion is exposed to extremely low temperatures, the structure of the tissue will be disrupted, which will cause its death. Cryodestruction is rarely used as an independent therapy, but together with other methods its effectiveness will be at a high level.
The procedure is painless, but the patient may require local anesthesia from the doctor. For large scars, you need to undergo 2-3 cryodestruction sessions, for small scars - one.
Excision of keloid scars
Excision of keloid scars is a surgical procedure, the essence of which is to remove the changed tissue and re-suturing the edges of the wound. The problem is that there remains a high risk of relapse - a new keloid scar forms at the site of the operation already performed. Therefore, doctors immediately after excision prescribe various therapeutic procedures - from injections to external agents.
It is completely impossible to get rid of keloid scars, but making them less noticeable is quite possible. To choose a treatment method, you should consult a doctor who will assess the work ahead and the risks, select the right direction of therapy, or immediately prepare the patient for surgery.
Useful video
Watch this video about what myths exist about scar treatment:
Preferanskaya Nina Germanovna
Associate Professor, Department of Pharmacology, Educational Department, Institute of Pharmacy and Translational Medicine, First Moscow State Medical University. THEM. Sechenova, Ph.D.
Most often, scars form on the ears, chest, shoulders, back of the neck, and less often on the joints. There are known cases of the development of keloid scars on the face. In children, keloid scars can form at the site of burns on any part of the skin. A keloid can cause not only physical but also psychological discomfort, especially if the scar has formed on the face, arm or any other visible part of the body. The causes of keloid scars have not been established.
There is no pattern between the severity of injury and the severity of keloid scars. They often occur after a third degree burn, or can after minor injuries (an injection or an insect bite). Keloid scars form when the normal tissue healing mechanism, the normal scarring process, is disrupted. This may be due to improper alignment of the wound edges, excessive skin tension, or individual characteristics the body's immune system.
With normal scarring of the skin, a softening stage necessarily occurs, the scar turns pale, becomes soft, mobile and painless. In the case of keloid scars, this stage does not occur, and the scar remains dense, rough and inelastic. A keloid scar has a dense consistency, with a smooth shiny surface and reduced elasticity of the fibers, rising above the skin by 5-8 mm. This type of scars is considered the most unaesthetic.
The morphological basis of a keloid is made up of excessively growing immature connective tissue with a large number of atypical giant fibroblasts that remain in a functionally active state for a long time. Keloids contain few capillaries, mast cells and plasma cells. Growth occurs over several weeks, sometimes months, after which the size of the keloid does not change until the end of the patient’s life.
It is characteristic that keloid scars almost never ulcerate, but their appearance is accompanied by increased sensitivity in the area of damage, pain, burning and constant itching.
Keloids are divided into young and old. Treatment tactics for these two forms are radically different. Young keloids - with a lifespan of 3 months to 5 years - are characterized by active growth, have a smooth shiny surface and a color from red to cyanotic (bluish). Old keloids - with a lifespan of 5 to 10 years - are characterized by an uneven wrinkled surface, sometimes recession of the central part, and have a paler color with a pinkish tint.
Antikeloid drugs used to prevent the occurrence and treatment (softening and elimination) of keloid, hypertrophic scars.
The drugs are used only externally for the treatment of keloid scars after burns, operations, injuries, wound surfaces, ulcerative-necrotic diseases, for cicatricial deformities of the skin and for the treatment of adhesive disease. Do not use the drugs on open areas of the body, with damaged skin, or apply to infected wounds.
MA No. 12/16 - 1/17 provided information on enzyme preparations (Chymopsin, Longidaza, Collagenase, etc. ) , which are used topically in medical practice to break down fibrin formations and resolve scar contractures. Let's add here a number of drugs containing other effectively active substances.
Contratubeks- a combined drug with proteolytic activity that promotes the resorption of keloid scars. Its action is due to the properties of the components: heparin sodium 50 IU, allantoin 10 mg And liquid onion extract 100 mg. Thanks to Serae bulb extract the drug has a fibrinolytic, anti-inflammatory effect, due to heparin- antithrombotic and keratolytic (dissolution of the upper keratinized layer of scar tissue) effect of the component allantoin. Stimulates cellular regeneration without hyperplasia and inhibits the proliferation of keloid fibroblasts, thereby regulating the natural healing process of wound surfaces without the formation of a rough keloid scar or an ugly scar.
Currently, a long-acting Kontratubeks patch is produced for the treatment of scars. Treatment with it for 3 months (min) prevents the formation of large, rough, uneven scars that have a cosmetically unaesthetic appearance. The application of the patch reduces the itching, burning and tightness that typically occurs during scar formation, while protecting the sensitive surface of the skin from damage. Its use creates an occlusion effect with a soft air microcushion and moderate physiological pressure on the tissue, which prevents transepidermal loss of moisture from scar tissue and creates favorable conditions for the normal restoration of connective tissue fibers.
Kelofibrase(50 g cream, tube) is a drug with anti-scar activity, the main component of which is natural moisture-containing urea, which, in fact, ensures the constancy of fluid balance in scar tissue. Normalizes tissue trophism by improving microcirculation, saturates pathological areas of the dermis with fluid and maintains their water balance. Blood supply and regeneration of scar tissue improves. The drug has an antiproliferative effect, eliminates allergic manifestations, softens the collagen matrix and increases tissue hydration. The drug has a resolving, keratolytic effect. Urea has a moderate bacteriostatic effect and is destructive against fungal microorganisms. The drug contains sodium heparin, which has antithrombotic and anti-inflammatory effects. With this route of administration of heparin, its anti-inflammatory effect is significantly superior to its antithrombotic effect. The dextrorotatory natural D-camphor contained in the drug suppresses inflammatory processes in scar tissue and has an analgesic effect. Against the background of local irritation of nerve fibers, it promotes dilatation of capillaries and thereby enhances the trophism of hypertrophied areas of the skin. Camphor also has antiseptic properties. The drug is applied 2-3 times a day. The course of treatment lasts from a month to six months, depending on the size of the damage.
Dermatix(gel 6 g, 15 g, tube) - this is the first line of drugs for the treatment of patients with scars, based on an inert silicone. Silicone is recommended by international experts for its action on scar tissue. The drug acts superficially, without having a systemic effect on the patient’s body, which makes it possible to use it in a wide range of people. A special formula of the drug is used to get rid of scars and scars and to return the skin to a smooth and even appearance. Forming an invisible film, the gel dries very quickly and has a softening and keloidolytic effect on the affected areas. The main mechanism of action of the gel is to maintain the natural balance of skin moisture, reorienting collagen fibers, which significantly improves the appearance of scars and allows for their smoothing. Under the pressure of the silicone film, collagen and elastic fibers acquire a horizontal orientation, protruding scars are smoothed and softened, itching is eliminated, alleviating the patient’s discomfort.
The drug is used in the treatment of atrophic structures and muscle contractures that interfere with the free mobility of the body and also spoil its aesthetic appearance. It is prescribed to reduce the size of skin scars during their healing, as well as for the prevention and treatment of hypertrophic and keloid scars after surgery, burns, and other injuries. Since the drug does not have a systemic effect on the body, the likelihood of side effects comes down to zero. In very rare cases, redness and a slight burning sensation may occur.
Silicone is also included in other drugs, such as Zeraderm (Zeraderm ultra), produced in tubes of 15 g. The drug "Zeraderm Ultra" belongs to the class of surface-adhesive elastomers, which, in addition to silicone, includes vitamins A, E And coenzyme Q10. The latter has an antioxidant effect, enhances the action of enzymes, stimulates reparative processes in rumen tissue, and participates as a substrate for tissue respiration. The drug has an antipruritic, antiallergic effect. The anti-inflammatory effect is realized by inhibiting the production of biologically active agents.
Scar Aesthetic- the cream contains silicone, onion extract, arnica, chitosan, beta-carotene, shea butter etc. The cream is used to treat burns, injuries, surgeries and stretch marks.
Kelo-Kot(Kelo-Cote UV) - innovative silicone gel (6 g, 15 g) or spray (50 ml, 100 ml), contains polysiloxane- silicone, a type of organic derivative of silicon, and silicone dioxide- the most effective substance, additionally contains an SPF15 filter against UV rays, used in non-invasive techniques in the treatment of scars, burns and cicatrices. The advantage of these forms over conventional silicone pads shows that the latter can cause irritation or infection of the skin; they are inconvenient to fix on the body during physical activity and sleep.
Skarguard— the drug contains silicone and an anti-inflammatory component hydrocortisone, antioxidant - vitamin E, available in the form of ointment, gel-cream.
Regivasil gel contains silicone, emu oil, vitamin C, squalene and is suitable for removing scars on the body and face.
Madecassol- a dermatoprotective agent of plant origin, the active ingredient of which is a product isolated from a plant Centella asiatica, known for anti-inflammatory, antimicrobial and anti-burn properties, stimulates tissue regeneration, inhibits the growth of fibroblasts and stabilizes lysosomal membranes. The drug acts on various stages of collagen synthesis by fibroblasts, increasing its quantity, promoting blood microcirculation and skin regeneration, developing elastic tissue and restoring the collagen structure of the vein wall. The drug clears ulcerative lesions with their subsequent marginal healing and reduces swelling. Apply externally, apply ointment to the affected surface (pre-treated with an antiseptic) 1-2 times a day.
Mederma(gel 20 g, tube) contains allantoin + tsepalin(from Serae onion extract). Allantoin is an active substance that collects and retains moisture in the surface layers of the skin, improves blood circulation, has a regenerative, anti-inflammatory, antibacterial and keratolytic effect. Serae onion extract, which has an anti-inflammatory and antibacterial effect, promotes skin cell renewal and stimulates collagen production. Cepalin has a fibrinolytic effect, promotes the dissolution of blood clots, and also limits the proliferation of scar tissue cells.
The drug is effective in the fight against small cosmetic scars and scars remaining after the removal of tattoos, acne and other skin damage. Used to smooth out scars and scars, it is especially effective against stretch marks formed during pregnancy or rapid weight loss. Significantly improves the appearance of the skin, restores the ability of stretch marks to respond to ultraviolet rays, due to which the skin acquires an even tan and makes stretch marks less noticeable. The drug is used exclusively externally and only on healed areas of the skin. The gel is applied 3-4 times a day to previously cleansed and dried skin and then for 3-5 minutes. rubbed with soft pressing movements into the scar tissue or stretch marks until completely absorbed. The course of application is 3-6 months.
Fermenkol(gel 10 g, 30 g, tube) - enzyme product from collagenases of hydrobionts, which is a complex of collagenolytic proteases with different molecular weights. It has high collagenolytic activity, providing deep hydrolysis of collagen peptide bonds. Hydrolysis of collagen occurs down to individual amino acids. Fermenkol exhibits selective activity against pathological collagen molecules with nodular and vortex folding, characteristic of keloid and hypertrophic scars, and is less active against fibrils of native collagen inherent in healthy tissue. The enzymes included in the composition selectively act only on the molecules of pathological collagen contained in the scar tissue of atrophic and keloid scars, destroying them, resulting in a reduction in the scar. Hydrolysis of collagen and elastin fibers occurs, which break down into individual amino acids. It only acts on scars that are less than 1-2 years old, when scar tissue formation is still active. Use no earlier than 2-3 weeks after wound granulation. Transdermal delivery of the active substance into the deep layers of the skin is ensured by a unique patented formula that reversibly increases the permeability of the stratum corneum due to the hydration of corneocytes and corneodesmosomes, as well as the epidermis and dermis by swelling and loosening of interstitial collagen and elastin.
The use of electro- and phonophoresis during application makes it possible to increase the delivery of enzymeolytics to deep areas of scarred skin. Applications are applied 2-3 times a day. Course duration is 30-40 days, break 10 days.
Limus(Tambukan mud) is an organomineral colloidal formation of black or dark gray color with an ointment-like consistency from the bottom of the salt lake Tambukan in the Stavropol Territory. The mechanism of action of the product is based on reflex (thermal and mechanical) action and the penetration of biologically active substances through the skin or mucous membrane. In the course of research, it was found that Limus has a wide spectrum of action: analgesic, anti-inflammatory, bactericidal, immunocorrective and desensitizing. The drug is good for treating skin scars after chemical and thermal burns and traumatic injuries. Treatment with mud deposits from Lake Tambukan is one of the powerful healing factors of the Caucasian resort Mineralnye Vody. Treatment with these drugs can be carried out not only at the resort, but also at home in any region.
A keloid scar is a consequence of skin trauma with pathological growth of connective tissue. It occurs approximately six months after healing in the wound area. It can grow over the course of 2 years, after which it stabilizes. People between 10 and 30 years of age are more likely to develop keloids.
The pathology has virtually no effect on overall health and well-being; it only causes psychological discomfort and emotional distress.
It differs from a regular or atrophic (retracted) scar:
- pinkish or bluish tint (due to the large number of blood vessels);
- redness of the skin around;
- complete preservation of sensitivity;
- the appearance of pulsation, pain and itching (intensified by friction of clothing);
- the formation of tubercles and compactions.
Who should I turn to for professional help to get rid of the defect? If a keloid scar has formed, treatment is carried out by dermatologists, surgeons and physiotherapists.
Causes of keloid scars
When magnified, a keloid looks like a tortuous nodule of collagen. Pathological tissue tends to grow, affecting healthy cells of the dermis. The skin most prone to the formation of keloid scars is the face, hands, earlobes, neck and chest.
The exact cause of the pathology is still not known. It is noted that this type of scar can occur both with complex extensive injuries and with subtle injuries such as a pimple, injection and insect bite. There are cases where, for unknown reasons, keloids form on healthy skin.
Why do moles form after removal?
Nevi and warts can be removed as planned, without hospitalization. This is a fairly simple operation for both the doctor and the patient. Sometimes a keloid scar forms. It appears due to the uncontrolled proliferation of connective tissue at the site of traumatic amputation.
This postoperative complication is not dangerous to health, but requires the attention of a doctor. When the first symptoms of a keloid scar appear, you should consult a dermatologist or surgeon. This type is often similar in appearance to a dangerous complication - basal cell infiltrating malignant tumor. It is almost impossible to distinguish one pathology from another without histological examination.
Who's at risk
Common factors that contribute to the formation of scar tissue include:
- family history, genetic predisposition;
- metabolic and immune processes disorders (diabetes mellitus, HIV, obesity, connective tissue diseases);
- young age, puberty, pregnancy;
- black race;
- chronic infections;
- long-term use of NSAIDs, corticosteroids and other systemic agents;
- herpes zoster, erysipelas, chicken pox.
Local reasons contributing to the formation of keloid are:
- inflammation and poor circulation in the area of injury;
- tattoos and piercings;
- skin pigmentation;
- traumatization of an already formed young scar, for example, by a foreign body;
- wound infection;
- burns and acne;
- healing of damage by secondary intention;
- improper alignment of skin edges.
Differences between keloid scars and hypertrophic ones
After an injury, the body undergoes a regeneration process. In this case, a regular flat scar forms on the surface of the skin in the area of the wound. Sometimes during healing it can suddenly begin to thicken, then a hypertrophic or keloid scar appears. These types of connective tissue growths have many differences:
Treatment methods for keloid scars
There are two methods for removing keloid scars: surgical and therapeutic. The overgrown connective tissue is surgically excised, followed by suturing of the skin edges. After the intervention, an inconspicuous, thin scar remains, which is easier to correct. Negative side method – high probability of recurrence.
Other treatment methods are aimed at transitioning from the hypertrophic to the normotrophic form of the scar. As a result, the scar becomes less noticeable. Which removal route to choose is determined by a qualified doctor, taking into account the size, location, shape, and old age of the formation. It is most effective to combine several methods of therapy at the same time.
Drug treatment
It is impossible to remove keloids using drugs. Medicines can stop the growth and make the scar less noticeable. This therapy is also effective after surgical excision. The most commonly used medications include:
- Hyaluronic acid is the central substance that regulates the density of formation. Therefore, the drugs that contain it can soften tissue and lighten the scar. The most commonly used are enzyme agents (Lidaza, Ronidaza, Longidaza). Injections are made directly into the pathological area, in a course of 5 to 20 injections. More effective for young keloids.
- Interferon helps stop the proliferation of connective tissue. It increases local immunity, which helps stop scar growth. For the first two weeks, the drug is injected into the pathological area every day, and then 4 times a month.
- Corticosteroids (Dexamethasone, Diprospan, Prednisolone ) have a strong anti-inflammatory effect. Therefore, they are used to treat young keloids, the growth of which occurs with inflammation in the tissues. Most often, injections or electrophoresis are used to administer hormones.
Cryodestruction
Consists of affecting the scar low temperatures. The procedure is carried out by freezing pathologically overgrown tissues, destroying their structure. To enhance the result, it is often used in combination with microwave therapy.
Laser resurfacing
Using a laser, a specialist can remove the part of the scar protruding above the skin layer by layer. In this case, evaporation of pathological tissues and sealing of blood vessels occurs. An erbium and neodymium laser is used to carry out the manipulation. The first affects only the superficial layers of the keloid, the second can penetrate to a depth of up to 8 mm.
Can help make the scar almost invisible. The disadvantage of the method is the cost. For example, one procedure to remove a scar on the face will cost approximately 6,000 rubles. The price depends on the clinic, the qualifications of the doctor, the number of necessary manipulations, the size and location of the formation.
Pressotherapy
This is compression of the area where the keloid has formed, with inhibition of microcirculation in the pathological area. Due to local ischemia, the production of connective tissue and collagen is reduced, and the growth of the keloid completely stops or slows down. The compression effect is achieved using elastic bandages. The bandage must be worn, almost without removing, for a year.
Physiotherapy
This type of treatment is used in conjunction with medication. To smooth out and stop the growth of the scar and destruction of its tissues, the following are suitable:
- apiphorelectrophoresis - exposure to ultrasound with the application of a small amount of bee venom, used to treat burn scars;
- infrared irradiation (Sollux and Minin lamps) and galvanization to treat infection, dry out and quickly heal the wound, with a predisposition to the formation of keloids;
- diadynamic therapy is used to prevent excessive development of collagen fibers;
- paraffin treatment and darsonvalization are performed during the wound healing period;
- phonophoresis, ultrasound therapy, infrared radiation, electrophoresis with 5% iodine, mud therapy - used after complete epithelization of the scar in the presence of a dense scar to absorb excess fibrous tissue;
- bukki therapy – activation of scar reverse development using x-rays;
- hirudotherapy - biologically active substances released when leeches are sucked on, promote the resorption of compacted tissues.
Correction with cosmetic procedures
Not very effective for keloids. Use is possible only in combination with other treatment methods. They help to slightly correct the appearance of the formation, only if it is no more than six months old. Cosmetologists offer:
- mesotherapy;
The sooner therapy begins, the better the result can be achieved. There is no universal way to treat keloid scars; only an integrated approach will help make the scar less noticeable and reduce the likelihood of relapse.
Local therapy products - ointments and medicinal dressings
Using gels and ointments, you can lighten and make scar tissue softer. Their use is comfortable and painless for the patient. To achieve the desired effect, treatment creams must be used for at least six months. The most popular local remedies include:
- Contractubex;
- Clearwin;
- Kelofibrase;
- Imoferase (also used for old scars);
- Dermatix (silicone based);
- Fermenkol (suitable for both adults and children);
- Solcoseryl;
- Hydrocortisone ointment.
Sometimes, to enhance the effect, ointments are applied in the form of cream dressings with the addition of Dimexide. It promotes deep penetration of the drug into the tissue. A similar result can be achieved using a gel silicone patch.
Treatment at home with folk remedies
There are many folk recipes to get rid of keloid at home:
- Melt Vaseline in a water bath, add 5 g of mumiyo and 25 ml of water. Stir and keep on fire until the solution changes color. After this, remove the mixture from the stove and cool to room temperature. The resulting homemade ointment should be applied in a thin layer 1-2 times a day for at least 1.5 months.
- Grind the cabbage leaves in a blender. Mix in equal proportions with honey. Use the product at night as a compress.
- Lubricate the keloid scar 2-3 times a day with one of the following substances: lemon juice, sea buckthorn oil, apple cider vinegar, aloe juice, olive or camphor oil with honey and propolis, infusions or decoctions of chamomile, St. John's wort, geranium and nettle.
Keloids cannot be removed using folk remedies. But with regular use, they will help soften and make pathological tissue less noticeable. You can treat yourself at home only after consulting a doctor.
How to get rid of old scars
Keloids are considered old if they are more than 5 years old. By this time, the scars do not increase in size and have a pale tint and a wrinkled surface. Their treatment is complex and lengthy.
Old scars can disappear completely only through plastic surgery with skin grafting. Excision in combination with other treatment methods suitable for young scars (physiotherapy, ointments) helps to make the keloid less noticeable.
Let's sum it up
There are many methods for getting rid of keloid scars. To achieve the best effect from treatment, you need to see a doctor as soon as possible. As a rule, the best results are achieved by combining several types of therapy.
Do you know firsthand about keloid scars? Have you tried some types of therapy? Do you know how to effectively and permanently remove scars? We will be glad if you leave a review and share your experience.
Few of us have not suffered wounds or damage in the form of cuts, burns or inflammation. At the site of deep wounds, traces remain called keloid, atorific or normotraphic scars, which have a pronounced cosmetic defect and cause a lot of discomfort to their owners. Keloid scars are especially problematic, because they tend to grow beyond the wound and have an ugly appearance.
It’s good if these marks are hidden under clothes. But if it is the open areas or face that are disfigured, then such patients more often than others request removal of keloid scars or at least making them invisible.
Why do keloid scars appear?
Keloids- this is dysregeneration of the connective tissue of the deep skin layers, which looks like a tumor-like formation with a smooth surface, rising above the skin level. Most doctors adhere to the theory that the process of formation of gross scar changes in the skin is influenced by a violation of the mechanisms of connective tissue formation. If wound healing occurs without suppuration, then the marks from them will not be so ugly. Otherwise, the size of the scar may eventually exceed the size of the wound itself.
Externally, keloid scars have a bluish or purple color, sharply defined edges and boundaries that extend beyond the boundaries of healthy skin. Scar formation goes through several stages, and this process can take several months.
One of the leading factors influencing the shape and size of a keloid is the activation of fibroblast cells, which are responsible for the destruction of old cells and the formation of new ones, as well as for the production of collagen and elastin. Normally, this process is in balance, but when there is an imbalance, the amount of collagen fibers produced increases, which ultimately affects the appearance of scars.
Methods for correction and removal of keloid scars
Treatment of keloid scars is carried out both surgically and therapeutically. The general tendency in treatment with therapeutic methods is to transform the rough hypertrophic form of the scar into a normotrophic one, that is, to make the scars almost invisible. Surgical treatment involves complete or partial excision of keloid scars.
Before choosing a method to get rid of keloid scars, you need to consult a doctor. The treatment method will largely depend on the location of the scars, size, shape, and age of the tumor. By age, scars are young (from 3 months to 5 years) and mature, older than 5 years.
Since the nature of the appearance of keloids has not been sufficiently studied, and the condition of the scar worsens with age, relapses very often appear after treatment of rough scars. That is why combination therapy methods are used in treatment.
All therapy methods can be divided into the following groups:
- Treatment with drugs.
- Therapy with physical and physiotherapeutic methods.
- Applications of radiation and x-ray therapy.
- Correction with cosmetic procedures.
Drug therapy
A course of drug treatment can be selected and carried out in one of the following ways:
- Injection of corticosteroids into the keloid scar tissue. In this case, there is a decrease in collagen production by fibroblasts. The number of injections is determined by the doctor, and the interval between them is 4-6 weeks.
- Interferon therapy is an immunomodulatory therapy. The drug is injected into the scar tissue, first every other day for 2-3 weeks, and then 1-2 times a week for 3 months.
- Medicines that stop the growth of connective tissue. Basically, enzymes (Lidase, Longidase, Ronidase) that break down hyaluronic acid are used for this purpose. This acid is the cementing component of the keloid scar. Treatment is also carried out in courses of 5 to 20 injections.
Treatment of keloid scars with physical and physiotherapeutic methods
The most commonly used methods are the following
Microcurrents. Using ointments or gels containing enzymes, you can perform electrophoresis, phonophoresis and other local procedures. Local products used include Contractubex, Aldara, Skarguard, Dermatix, Lyoton and others.
Squeezing. Compressive bandages and patches containing silicone can be applied to neoplasms. This treatment method is best used immediately after injury and scar healing. The treatment period can range from 2-3 months to 1 year.
Laser removal of keloid scars. The purpose of this procedure is to glue together the small capillaries that feed the scar tissue. The lasers used are carbon and argon lasers, as well as the method. To avoid relapses, this therapy is combined with hormone therapy.
Cryosurgery. Liquid nitrogen is applied in short (5-15 seconds) applications, which causes damage to connective tissue cells.
Surgical removal of keloid scars. Practice has shown that this approach often results in relapses, so it is used only for large scars in combination with other treatment techniques.
After excision of the keloid, it is customary to take measures to prevent relapses, which usually begin already at the stage of formation of a new scar (10-25 days). Prevention of keloid scars gives good results, since older formations are more difficult to treat than fresh ones. Among the preventive measures, all the above-described therapeutic methods are used. In addition, in order to prevent further growth, it is necessary to use sunscreens with a protection level of SPF 30 or more.
Radiation and X-ray therapy
The goal of therapy is to destroy fibroblasts and old connective tissue cells. Only the outer layer of the skin is irradiated, without involving deeper tissues in the process, which is achieved with a small dose of radiation.
Bucca radiation and X-ray therapy have many contraindications - these are diseases of the kidneys, liver, hematopoietic system, heart, blood vessels and other conditions.
Correction of keloids using cosmetic procedures
The purpose of such procedures is to eliminate external cosmetic defects of the skin. Small scars and scars with a period of formation of no more than 6 months are subject to correction. Of all the procedures, mesotherapy and mesotherapy are most often used. Treatment with cosmetic methods should not be aggressive, affecting the deep layers of the skin. It is advisable to carry out superficial procedures to avoid further growth of the scar.
