A keloid is a severe case of scarring, also known as a keloid. It is the proliferation of keloid scars far beyond the injury and is not related to the extent of the injury. The most common areas of the body where keloid scars occur are: the auricle, the median sternum, and the back of the shoulder.
The skin and cartilage of the auricle are prone to keloid scarring after injury, and is one of the areas of the body where keloid scarring is likely to occur. The most common cause of injury is pierced ears, commonly in the earlobe, followed by the earwheel. There are also burns, car accidents, and other causes of auricular injury that form keloids after healing. The symptoms are itching and tingling at the site of the lesion, which can worsen with weather changes or dietary stimuli. The appearance of keloid scars is spherical or even multiple spherical protrusions, with a purple-red complexion, tough texture and clear boundaries, much larger than the area of the ear hole or larger than the area of the original ear injury.
I. Causes of auricular keloids
1. First, it is caused by pollution
Poor aseptic conditions during ear piercing, the presence of bacterial inflammation, often redness, swelling, and pus flow, and later on, after healing, keloids will appear. After burns or other injuries, because of improper treatment of infection, or also bacterial infection within the scarred skin, these chronic bacterial inflammation recurring, will lead to keloid scars with large scope and heavy symptoms.
2. Secondly, foreign body irritation
The epidermis is left in the flesh of the earlobe or in the cartilage of the earwheel when piercing the ear, and the same can happen with various injuries, which eventually leads to keloid scars.
3. Then there is the tension of the wound
After an ear injury, the wound is forcibly pulled together and sutured because of the lack of skin, i.e. the wound tension is too high, and keloid scars tend to appear after healing. There are also doctors who remove the keloid and suture the incision directly afterwards because they do not understand the treatment concept of keloid, which can also cause the keloid to recur and worsen.
4. Finally, the patient is a keloid or a keloid prone to hyperplasia
Some patients are keloid, and most parts of the body will have keloid scars or even keloid scars if there is a slight injury. For example, after a mosquito bite, scratching causes epidermal damage and keloid scars appear. These patients will also develop keloids no matter how much damage is done to the auricle. Patients with easily proliferating keloids are also prone to keloid scarring after auricular injury and are prone to recurrence after treatment.
Treatment of auricular keloid
If you understand the causes of auricular keloid, then the treatment will have a purpose.
1, first of all, the keloid formed after ear piercing or sharps injury to the ear is more limited. We mainly remove the keloid within the keloid, right down to the cartilage surface, or even thin the cartilage and completely remove any foreign bodies that may be present. The skin on the surface of the keloid is preserved, the excess skin is cut away, and the incision is closed without tension. It is best to use oiled gauze staples for anterior and posterior pressure fixation to prevent subcutaneous blood leakage.
Such treatment, firstly, removes the possibility of foreign bodies within the keloid and secondly, the incision is tension-free. Such treatment can basically solve all auricular keloids.
2. For keloids formed after burns or large injuries, we believe that an effective treatment is to remove the keloid and the skin on the surface, and use skin implants or expanded skin to cover the trauma. The purpose of removing the foreign body and closing the wound without tension is achieved.
3. For patients with keloid or easy scar growth. We believe that surgical treatment for keloid patients should be cautious or even contraindicated. Patients who are prone to scar proliferation need comprehensive treatment, i.e. surgical excision + radiation therapy + drug injection therapy.
III. Whether every patient needs comprehensive treatment
1. We believe that for patients with keloid scars formed by simple ear piercing, as long as they are not keloid or prone to scar proliferation, careful surgical excision can completely achieve satisfactory and lasting results, and radiation therapy is not needed. After all, the damage of radiation to the human body is serious.
2. For patients with a tendency to recur, we can prevent recurrence with auxiliary steroid hormone local injections, which can be given once every other month for a total of 3~4 times. The side effects on the human body are extremely mild and can be completely assured.
3.Only for patients with keloid hyperplasia, we have to adjuvant radiotherapy and drug injection treatment after excision.
4.Does the auricular keloid need continuous compression after surgery? I think the effect is not obvious, firstly, compression is not easy to implement, and secondly, the effect is not obvious either. Compression is effective for keloid growths, but not for keloids.