Keloid Formation: Causes, Treatments, and Personal Experiences

Keloid predisposition

During high school, I developed acne on my shoulders and squeezed it.
To my surprise, it gradually grew larger.
After seeing a doctor, I was diagnosed with keloids and informed that it was a matter of my body’s constitution and would not improve.
I followed the doctor's advice and received steroid injections, but many years have passed, and it flattened only to grow back again.
I eventually gave up on seeing a doctor.
Later, after a fall and subsequent injury, the wound healed but left a prominent red area that concerned me greatly.
Recently, I noticed that my legs developed symmetrical skin lesions resembling folliculitis, which expelled yellowish, fatty substances when squeezed, but then they became swollen.
I am unsure if this is similar to keloids.
I am hesitant about surgery due to the possibility of leaving more unsightly scars.
The keloid lesions constantly remind me of their presence, causing intense itching and pain akin to being pricked by needles.
I am considering surgical removal, but what issues should I be aware of post-surgery? Is my obesity related to these issues? I noticed that when I was thinner, these problems did not arise.
Initially, I thought I was the only one with this condition, but I later discovered that family members also have it, though not as severely as I do.

Kunrao de wo, 20~29 year old female. Ask Date: 2006/08/27

Dr. Lu Shangbin reply Surgery

Hello, 1.
The condition of swollen feet is not related to obesity.
2.
The physician himself was once 120 kilograms and has never experienced such a condition.
It is recommended that you consult a plastic surgeon to understand the relevant treatment options, as medical advancements have significantly improved.
In the past, treatment involved corticosteroid injections or surgical removal, but now there seem to be other methods available.
The author is not a specialist in this area and does not wish to make any casual recommendations.

Reply Date: 2006/08/27

More Info

Keloids, also known as hypertrophic scars, are raised areas of scar tissue that form at the site of an injury or incision. They are characterized by an overproduction of collagen during the healing process, leading to a thick, fibrous tissue that extends beyond the original wound boundaries. Understanding keloid formation, its causes, and treatment options is essential for managing this condition effectively.

Causes of Keloid Formation
Keloids can develop due to various factors, including:
1. Genetic Predisposition: Some individuals have a genetic tendency to develop keloids, which can run in families. If you have a family history of keloids, you may be at a higher risk.

2. Skin Type: Keloids are more common in individuals with darker skin tones, particularly those of African, Asian, or Hispanic descent. This increased prevalence may be linked to differences in skin structure and healing responses.

3. Injury or Trauma: Keloids often form after skin injuries, such as cuts, surgical incisions, acne, or even minor abrasions. In your case, the acne on your shoulder and subsequent squeezing may have triggered keloid formation.

4. Hormonal Factors: Hormonal changes, particularly during puberty or pregnancy, can influence keloid development. This may explain why you noticed changes during your teenage years.

5. Inflammation: Conditions that cause chronic inflammation, such as acne or folliculitis, can also lead to keloid formation. The inflammatory response can stimulate excessive collagen production.

Treatment Options
While keloids are often resistant to treatment, several options are available to manage their appearance and symptoms:
1. Corticosteroid Injections: As you have experienced, corticosteroid injections can help flatten keloids and reduce itching or discomfort. These injections are typically administered every few weeks and may require multiple sessions.

2. Surgery: Surgical removal of keloids can be an option, but it is important to note that keloids can recur after surgery. If you choose this route, your doctor may recommend combining surgery with other treatments, such as corticosteroid injections or radiation therapy, to minimize the risk of recurrence.

3. Silicone Gel Sheets: These can be applied to the keloid to help flatten and soften the scar over time. They are a non-invasive option that can be used in conjunction with other treatments.

4. Laser Therapy: Laser treatments can help reduce the redness and size of keloids. This method may require multiple sessions and is often used in combination with other therapies.

5. Cryotherapy: This involves freezing the keloid with liquid nitrogen, which can help reduce its size. It is often used for smaller keloids.

6. Pressure Therapy: Applying pressure to the keloid using specialized dressings can help flatten the scar over time.

Personal Considerations
Given your experiences with keloids and the recent developments on your legs, it is understandable to feel hesitant about surgical options. It is crucial to consult with a dermatologist or a plastic surgeon who specializes in scar management. They can assess your specific situation, discuss the potential risks and benefits of surgery, and help you make an informed decision.

Regarding your concerns about obesity, while keloids themselves are not directly linked to weight, overall health and skin condition can be influenced by body weight. Maintaining a healthy weight through diet and exercise can improve your overall skin health and may help in managing keloid formation.

Lastly, since you mentioned that family members also have keloids, it may be beneficial to discuss this with them and consider genetic counseling if you are concerned about hereditary factors.

In conclusion, keloids can be a challenging condition to manage, but with the right treatment plan and support, you can find relief from symptoms and improve the appearance of your skin. Always consult with a healthcare professional to explore the best options tailored to your needs.

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