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5 ways to treat keloid scars

Keloid scars are an abnormal form of scarring that occur in some individuals.

They are more common in certain skin types such as Afro-Caribbean skin and they are also more common in certain areas such as the earlobes, the shoulders or over the breast bone.

They are raised lumpy scars which are often itchy and are darker in colour to the normal skin colour so they can be red or purple in Caucasian skin or darker brown in pigmented skin.

They are difficult to treat because it is an abnormal response by the body and we don’t really know why they occur.

There are five main forms of treatment for keloid scars:

1. Moisturising and Massage

If your scar is only slightly raised and particularly if it is within the first year then you may have a hypertrophic scar rather than a keloid scar and these tend to be less severe and more likely to improve over time.

Moisturising and massaging the scar will help it to soften and may help with the itch.

2. Silicone

The next step would be to use silicone on the scar.

Silicone comes in 2 forms, a gel or a sheet.

Silicone sheets are useful on flat areas particularly underneath clothes because while the silicone sheets are sticky, they do not stay on well on exposed areas.

For keloid scars in exposed places like the face or the ears, silicone gel is more effective.

The silicone needs to stay on for 23 hours of the day and is only taken off to wash.

It can help with the red and raised nature of the scar and also the itch.

3. Pressure

Pressure is known to improve the quality of keloid scars although it is dependent on the area as to whether it can be used as a modality for treatment.

Keloid scars on the earlobes may be amenable to having pressure applied by using a custom-made clip which will press on the scar and can help it to flatten.

Other areas of the body can be more difficult to apply pressure to although it may be possible to have a custom-made garment depending on the size and location of the scar.

For severe scarring of the face, a custom mask can be made to apply pressure, although this is only for extreme cases.

4. Steroid Injections

The next step for troublesome keloid scarring is to use steroid injections.

Steroids are used to dampen down inflammation and it is presumed that the cause of the keloid scarring is an inflammatory reaction within the scar.

The steroid needs to be injected into the scar itself and this can be uncomfortable.

Steroid injection is a procedure that can be performed in the outpatient clinic and may need to be repeated.

5. Excision Of Keloid Scars

One of the last options we consider, but perhaps one of the first options that many people think about, is excision of the scar.

It may seem an obvious choice to excise and give a fresh neat scar. However because keloid scarring is due to your body’s reaction to forming scars, there is a high probability that if a fresh scar was made, it could be keloid again and it could come back worse because the new scar would be longer than the original one.

Excision of a keloid scar is sometimes performed if it is a very large and bulky scar that is unlikely to be significantly reduced with steroid, pressure or silicone.

When excision of a keloid scar is considered, we would usually perform what is known as an intralesional excision of the scar which involves leaving a rim of keloid scar behind so that fresh skin is not cut into.

This leaves a residual lump which can then be treated with one of the other methods above such a steroid injection, pressure clips and silicone dressings or a combination.

 

 

The treatment of keloid scar is challenging and as you go up the ladder of increasingly invasive methods then the potential risks also increase.

This is an outline of what is available for keloid scars but each patient needs to be treated on a bespoke and personal level with a package or combination of treatments which will give the best possible outcome.

If you would like a consultation with one of our Plastic Surgeons for an assessment of your keloid scar then you can call us on 0121-454 3680, alternatively email us a photograph if you would like us to give you an opinion.

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For more information about scar revision, visit our scar revision page.

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What is Life-Changing Surgery?

I was invited to a talk on the radio this morning about scar management following a story of a football supporter who had been attacked and had sustained a long laceration to his cheek.
The conversation revolved around the scarring and the emotional impact of scars and what can be done about it.

I am always cautious when talking about scar revision because sometimes people think that plastic surgeons can remove a scar but that is not true.
I think we get that reputation because when we make a scar, we choose where to put them and know how to hide them in natural skin creases or in areas of the body where there are concavities or shadows, so that they can blend in and once settled, can be difficult to see.

Of course, it is a different story with traumatic scars and they are usually a lot more obvious than surgically created scars.
There are things we can do to change the direction of the scar and to improve them if they are raised up or dented in, which is interesting, because the discussion moved onto the psychological impact of having scar revision. 
It is true that the surgery itself is often quite minimal and usually done under local anaesthetic on a walk-in, walk-out basis and the results really can be truly life-changing – except when the definition of a minor operation is one that is not happening to you.
We as surgeons can sometimes think that we are performing minor surgery, but for the patient it can bring tremendous relief from the emotional impact of having an obvious scar, particularly if it is on the face and people’s eyes are drawn to it and they keep asking you about it.
If we can do something to help it blend in and make it less obvious, it can allow you to be you and not to be defined by your physical features.

And this is true of all cosmetic surgery.

It is often deemed to be unnecessary or for vanity reasons, but I think people’s perception is far off the average person seeking cosmetic surgery.
It is usually done for them and not for anyone else and they just want to feel more confident and happier about their appearance.

It was interesting talking to Danny Kelly this morning on BBC WM because it really made me think about the impact that we have on people’s lives and sometimes we can lose sight of this and get caught up in ‘the what we are doing’ rather than ‘the why we are doing it’.

I truly believe that cosmetic surgery can significantly improve people’s quality of life and I am often upset by the adverse media attention, which happens to be part of the positive image of plastic surgery this morning, as this is always what we are trying to achieve because everyone deserves body confidence.

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Scar Revision

Scar Revision At The STAIANO Clinic

You may think that scar revision is bread and butter for a plastic surgeon, but it is important to be aware of what is possible when it comes to considering revision of your scar.
It is not possible to remove scars completely, but plastic surgeons are trained in techniques to alter and improve scars so that they can be hidden or blend in with their surroundings.
If you think that you might be a suitable candidate for scar revision, then watch this video where our director, JJ Staiano, talks about what can be achieved with plastic surgery to help improve and reduce scarring.

What Scars Are Suitable For Scar Revision?

Not all scars are suitable for scar revision and you would be welcome to send us a photograph of your scar so that we can give you an assessment on whether we can help.
Scar revision is particularly suitable for scars that are stretched or indented or scars that are lying in an unfavourable orientation.  This is usually scars that are caused by some sort of trauma or injury rather than scars that have been made following surgery.
If you have a surgical scar, then it could be raised and lumpy and this is known as a keloid or hypertrophic scar.  Keloid scars are best managed by a qualified surgeon or dermatologist as they are difficult to treat and there is a risk of causing more keloid scarring if surgery is performed.
We have a wealth of options to treat problematic scars at The STAIANO Clinic ranging from non-surgical treatments such as silicone gel that can be applied to your scars to steroid injections that we can perform here at the clinic through to surgical revision to improve the look of your scar.

Before - Puckered Scar

Before Scar Revision – Puckered Scar

After Scar Revision - Puckered Scar

After Scar Revision – Puckered Scar

 

Before Scar Revision - Stretched Scar

Before Scar Revision – Stretched Scar

After Scar Revision - Stretched Scar

After Scar Revision – Stretched Scar

When plastic surgeons perform scar revision surgery, they are creating new scars and so the aim is to create a new scar that is better than the old scar.  It is very much a bespoke service that we offer and we will assess your scar and take a full history so that we can offer you the best treatment for your scar and give you the best result possible.

When Is The Best Time To Undertake Scar Revision Surgery?

All scars take 6 to 12 months to mature and so you should not consider scar revision until your scar has fully matured and is going to be as soft and supple as it is going to get.
It may sound counter-intuitive to wait until your scar has fully settled before undergoing revision, but it it is important for it to have softened and settled fully before undergoing further surgery.

Want To Find Out More About Scar Revision?

Find out more about removing your scar on our scar removal page.
All of the surgeons at The Staiano Clinic are fully trained plastic surgeons and have extensive experience in managing scars and obtaining the best outcomes possible.
For more information, call us now on 0121-454 3680 to book a FREE consultation with a Consultant Plastic Surgeon or you can send us a photograph of your scar to info@staianoplasticsurgery.co.uk and we will get back to you with an idea of what can be achieved.