Keloid scarring is a pathological phenomenon unique to humans that manifests as excessive tissue proliferation beyond the original damage during the healing process after an injury to the skin.
Keloid scars have the following characteristics: 1) significant predilection for the sternal stalk, shoulder deltoid, auricle, jaw and upper back; 2) long duration of the lesion, which may expand into the surrounding normal skin; 3) inability to be cured by surgical excision alone, and after excision, they are prone to recurrence and may grow larger and faster than the original scar; 4) no obvious relationship with the severity of the skin damage, and minor trauma such as mosquito bites, vaccinations and other injections. Minor traumas such as mosquito bites, vaccinations, and other needlestick injuries can form keloids.
The pathogenesis of keloid scars is still unclear and is generally considered to be related to the individual’s constitution. The current theory is that the occurrence of keloid scars may be related to genetics and immunity. Some scholars believe that the hypoxic environment of the scar tissue encourages cells to secrete growth factors that cause the tissue to overproliferate.
The treatment of keloid scars is mainly a combination of drug-based treatments, and special attention is needed to avoid pure surgical excision.
Currently, the following treatments are commonly used: 1. Corticosteroids (such as short-acting tretinoin and long-acting Depo-Provera) are locally closed, which have been widely used at home and abroad. The hormones can accelerate protein degradation and inhibit fiber and vascular proliferation; 2. Oral immunomodulatory drugs, such as trinostat, alleviate tissue proliferation by inhibiting the release of various growth factors and inhibiting fiber synthesis, but the required course of treatment is longer; 3. Physical therapy methods, such as cryotherapy, laser therapy, photochemotherapy, superficial X-ray irradiation, ion beam irradiation, and compression therapy, which can soften and flatten the scar.