Scars - Keloids

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Scars - Keloids

Scars are visible marks left on the skin after an injury as the body’s healing mechanisms are activated to maintain the structural and functional integrity of the damaged tissue.

Treatment

The treatment of scars & keloids is a long and demanding process. The effectiveness of each treatment can vary from person to person, and regular repeat sessions are often required to achieve the desired result.

At Cosmetic Derma Medicine, the treatment approach taken is chosen depending on the type of scarring and after a clinical evaluation of each case by a Dermatologist. The methods used to successfully treat scars & keloids are as follows:

DR TSIATOURA EXPLAINS THE TREATMENT

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Causes

Scars are normal signs that exist in every human being. While many scars are due to unknown causes and are naturally present on the body from birth, most scars are created after trauma or even more commonly after acne. They are a fairly significant aesthetic problem, especially in people who are in their teens.

The inflammatory signs of acne are papules and pustules and are formed when a hair follicle pore is filled with sebum, dead skin cells and bacteria. The pore gradually swells and a rupture in its wall is caused. If this rupture occurs close to the epidermis, then healing does not create a significant acne scar. However, if it occurs deeper, then the epidermis fills with inflammatory elements and bacteria destroying healthy skin and leaving behind a lot of tissue destruction leading to acne scarring. The most common areas of acne scarring are the face, back and chest. Less commonly, acne scars also appear on the buttocks. Apart from acne scars, there are several other types of scars that form after varicella, after trauma or burns, and also scars that form after surgery. Even stretch marks, formed after pregnancy or from sudden weight fluctuations due to skin stretching, are a form of scarring.

Acne scars are formed either due to loss of skin tissue or due to increased skin tissue formation during healing. Inflammation is a key factor in the formation of acne scars and the greater the inflammation, the more likely the formation of acne scars. Acne scars are divided into two main categories, atrophic and hypertrophic. Also, in some cases acne can lead to keloids. All three categories have one thing in common: they are created due to the body’s response to inflammation.

Categories

  • Atrophic acne scars

    They are the most common category of acne scars and are created due to loss of skin tissue after inflammation. Atrophic acne scars are divided into two categories, “ice pick” which are narrow and deepened acne scars and difficult to treat, and “boxcar” which are wide and deepened. Ice pick scars are less than 2 mm in size, but quite deep, reaching deep dermis or subcutaneous tissue.

    They get their name because of their shape, which is like being hit by a sharp object, such as an ice pick. On the other hand, boxcar-type scars are wide and can be either shallow (0.1-0.5 mm deep) or deeper (more than 0.5 mm deep). They are more rounded and usually have sharply defined vertical sides.

  • Hypertrophic acne scars

    They are created by excessive tissue production during healing and are usually asymptomatic. They are bright red in color, are hyperechoic, confined to the wound margins and appear shortly after injury.

    Usually, they improve over time and gradually become pale in color. Hypertrophic scars can form on the skin of a person of any age and are common in both sexes.

  • Cheloid acne scars

    In rarer cases, acne can lead to keloid scars. These are unshapely hypertrophic scars most commonly located on the back, chest, shoulders.

Causes of Appearance

Under normal conditions, the formation of scars is due to the parallel action of the functions of anabolism and catabolism. To cope with the damage, the epidermis creates new collagen fibres, a fibrous protein that restores skin cohesion. Unfortunately, the deposition of collagen in the acne scar does not occur in an orderly fashion but rather anarchically, disrupting the architecture of the skin. During healing, the body produces a lot of collagen, which creates a scaffold in the skin. This increased collagen production is due to increased anabolism activity.

Cheloid acne scars can be caused in some cases of severe acne in predisposed individuals. These are the excessively hypertrophic acne scars that usually appear on the back, shoulders and chest. Cheloid acne is characterized by unsightly, large scars and treating these unsightly acne scars is usually very difficult.

Keloids often also form after skin injury such as burns, surgery and vaccination or after tattooing (tattooing). They most commonly occur on the back, chest and neck, as well as on the chin and earlobes. They most commonly affect darker skin, and have a particular preference for the female sex and black race. Usually, the causes of keloids are hereditary or due to endocrine factors.

Morphology

Unlike hypertrophic scars, keloids grow beyond the boundaries of the original lesion and are significantly larger in size. Typically, they are hematogenous, red and are due to abnormal excess collagen and glycosaminoglycan synthesis, resulting in the production of excess extracellular substance and hyperplasia of the skin at the site of injury.

In addition to the aesthetic deformity and negative psychology that keloids can create in patients, very often they can also be symptomatic causing itching and pain. Unlike other forms of scarring, keloids do not recede and become milder over time.

In general, scars do not raise the appearance of other symptoms. Cases have, of course, been recorded in which the patient felt pain in the scar, itching or even inability to move due to skin shrinkage.

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