Treatment of keloids

Written by Liu Gang
Dermatology
Updated on September 04, 2024
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The formation of keloids is somewhat related to an individual's scar constitution. Once keloids have formed, there is a lack of a perfectly effective treatment plan. The most commonly used treatments are topical ointments, which can't completely solve the problem. The most frequent treatment involves local application of steroid medications, which can be chosen based on the size of the keloid to be treated 2-3 times, or even four to five times. After treatment, the keloids will gradually shrink, become softer, and smaller, but they will not completely disappear. If the keloid proliferation is not particularly severe, one can also visit a dermatology department at a formal hospital to use fractional laser treatment. Currently, there are many other drug treatments available, but their ultimate effects are not certain, so it is best to prevent such conditions in individuals prone to keloids, avoiding external injuries or scars.

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Can scars soften and flatten?

Scars are related to the size and depth of one’s own trauma, and some patients have a scar constitution, where even a small wound can leave a relatively large scar. Once a scar forms, it cannot be completely eradicated, but topical medications or local injections can be used to gradually soften and flatten or shrink the scar. However, this condition also has a certain recurrence rate, such as often consuming spicy and stimulating food, drinking alcohol, or when the body is inflamed, which can lead to the scar proliferating again. Therefore, this condition cannot be completely cured. After treatment, it is essential to avoid spicy and stimulating food for a long time, not to irritate or scratch the area, and to strengthen exercise according to one's immunity, and take some medications to enhance the immune system.

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What does "scar constitution" mean?

Scar constitution is a type of special genetic constitution, typically leading to larger scars from minor injuries, especially in areas such as the chest and back where skin and muscles are tense. People with scar constitution should avoid injuries or bumps, particularly avoiding scratching or squeezing folliculitis on the chest, as scars formed are difficult to completely remove. Common anti-scar medications often do not work well. If scar proliferation is significant, treatment with medical injections in a standardized hospital's dermatology department may be required. Regular exercise, boosting the immune system, avoiding spicy or irritating food, and avoiding staying up late can help reduce the frequency of this condition.

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Written by Zhang Da Wei
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What should I do if I have pain from hypertrophic scars?

Once an injury occurs, it is very likely to develop hypertrophic scars, and the appearance of such scars is related to the individual's constitution, often accompanied by symptoms such as pain. When this condition occurs, specific treatments are definitely needed for improvement, typically using laser surgery as the main treatment, or it can be removed at once through surgical operation, which helps improve the condition. Of course, hypertrophic scars can also be improved through some physical therapy methods, such as by adjusting in different degrees, like acupuncture, which can fade the scars by improving local blood circulation. However, physical therapy is just one aspect; consistent improvement in lifestyle habits to avoid recurrent stimulation of hypertrophic scars is also crucial for recovery.

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What are hypertrophic scars like?

Hypertrophic scars are actually directly related to a scar-prone constitution, and generally, when such scars occur, they are divided into several types. The first type is caused by regressive changes, and the outcomes in this situation are generally quite ideal. However, improvement in these cases usually needs to be tailored to the specific circumstances. If the issue with hypertrophic scars is more pronounced, it can be addressed with laser surgery to achieve effective treatment. Of course, it requires specific analysis; not every issue in this regard necessitates intervention, but it should be addressed promptly. Moreover, if a scar-prone constitution persists, it might have some direct impacts. Decisions on improvement can be made based on the specific size of the scar area.

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The difference between hypertrophic scars and keloids

In a strict sense, hypertrophic scars and keloids are similar in their pathogenesis. For hypertrophic scars, the typical presentation is localized overgrowth at the scar site, which means that there is an overgrowth during the wound healing process, resulting in a relatively large and numerous scar. Keloids represent a more severe condition where there is a localized raised scar on the wound, which can be significantly large, sometimes resembling a bug on the surface of the scar. They are more likely to occur in areas like the neck, behind the ears, and under the earlobes. For the treatment of hypertrophic scars and keloids, if the patient has a predisposition to scarring, considerations include early intervention during wound suturing and healing, such as injection of medications or radiation therapy.