Can BCG Vaccine Administration Prevent Keloid Formation?

Is there a way to prevent the formation of keloids after receiving the BCG vaccine?

Hello, Doctor! My daughter will be five months old next month, and we are about to schedule her BCG vaccination.
However, my wife has a keloid tendency and has a long, thick keloid scar on her left arm.
Therefore, we are very concerned that our daughter may also develop a similar condition after the vaccination.
I would like to ask if there are any relevant studies or literature in current medical practice that suggest ways to prevent keloid formation before and after the BCG vaccination.
For example, can we change the injection site, or are there specific care instructions post-vaccination that could help prevent this? Thank you very much for your attention and response!

Nick, 30~39 year old female. Ask Date: 2023/01/09

Dr. Wu Yuxin reply Dermatology

In principle, it is important to take good care of the wound, and there are scar prevention ointments that can be applied.
If you notice that the scar continues to grow, it is advisable to seek medical attention promptly, as there are treatments available that can reduce the formation of scar tissue.

Reply Date: 2023/01/09

More Info

The BCG (Bacillus Calmette-Guérin) vaccine is primarily used to protect against tuberculosis (TB) and has been studied for its potential effects on various conditions, including keloid formation. Keloids are raised scars that occur due to an overproduction of collagen during the healing process after skin injury. They can be particularly concerning for individuals with a predisposition to keloid formation, such as your wife, who has a history of keloids.

Current medical literature does not provide definitive evidence that BCG vaccination can prevent keloid formation. However, there are some considerations and recommendations that may help mitigate the risk of keloid development in your daughter when receiving the BCG vaccine.

1. Site Selection: One of the most important factors in preventing keloid formation is the site of injection. If your wife has a history of keloids on her left arm, it may be advisable to administer the BCG vaccine on the opposite arm or another area of the body where keloids have not previously formed. This can help reduce the likelihood of keloid formation at the injection site.

2. Post-Vaccination Care: After the BCG vaccine is administered, proper care of the injection site is crucial. Keeping the area clean and protected from trauma can help minimize the risk of excessive scarring. Avoiding tight clothing or any friction on the site can also be beneficial. If any irritation or abnormal healing occurs, it is important to consult a healthcare provider promptly.

3. Monitoring: After vaccination, closely monitor the injection site for any signs of abnormal healing, such as excessive redness, swelling, or raised scar formation. Early intervention can be key in managing potential keloid formation. If a keloid begins to form, treatments such as silicone gel sheeting, corticosteroid injections, or other dermatological interventions may be considered.

4. Consultation with a Specialist: Given your family's history of keloids, it may be beneficial to consult with a dermatologist or a specialist in scar management before the vaccination. They can provide personalized recommendations and may suggest additional preventive measures based on your daughter's specific risk factors.

5. Research and Evidence: While there are anecdotal reports and some studies suggesting that BCG may have immunomodulatory effects that could influence scar formation, more research is needed to establish a clear link between BCG vaccination and keloid prevention. Therefore, it is essential to approach this topic with caution and rely on established medical advice.

In summary, while there is no conclusive evidence that BCG vaccination can prevent keloid formation, careful consideration of the injection site, post-vaccination care, and monitoring can help reduce the risk. Consulting with a healthcare professional who understands your family's history of keloids will provide the best guidance for your daughter's vaccination. It is always important to weigh the benefits of vaccination against potential risks, and in this case, the protective benefits of the BCG vaccine against tuberculosis are significant.

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