Keloid Scars Part I

Scarred Hand

Increased Incidence of Keloid Scars

When a scar grows beyond or outside of the boundary of the initial wound it is referred to as a Keloid scar. Its hypertrophic appearance differs from hypertrophic scar in this fact. The thicker fibrous tissue in a hypertrophic scar is limited to the margins of the initial injury and does not continue to grow beyond them.

The definition of Keloid scars is an abnormal scar that grows beyond the boundary of the original site of a skin injury. Keloid scars are raised and are often without a defined border in the area where the injury and the skin where initially traumatized. Certain ethnic groups are clearly more at risk though Keloid can occur in anyone. Keloid scars occur 15 times more in ethnic groups with highly pigmented skin as compared to Caucasians. It is estimated that 10% of the world’s population is suffering from this under researched this disorder. After reading this important article series you have we urge you to watch the news video about one of the world’s leading experts on keloid scarring.

Epidemiology of Keloid Scarring

  • Approximately 700 million people are effected globally (10% of world population)
  • Ethnic groups with high levels of pigmentation are 5 to 15 times more often to keloid when compare to European Caucasians or of
    that ethic heritage
  • People of African descent and Latin/Indian ethnic heritage have a higher prevalence of 16%
  • The highest incidence is noted in persons in the twenties
  • Keloid scarring equally effects both genders
  • The incidence of keloid and hypertrophic scars combined ranges from 40% to 70% following surgery
  • The incidence skyrockets to up to 91% following burns

Etiology of Keloid Scarring

  • Traumatic wounds, surgery or body piercing can result in keloid
  • Burns
  • Injuries such as acne, folliculitis (from shaving or hair removal) insect bites, medical vaccination and similar such injury can
    result in keloid
  • Keloids rarely occur spontaneously, obvious injury is usually present
  • Ethic predisposition is present
  • Predisposition in families

Risk factors for Keloid Scarring

  • Family history of keloids
  • Personal history of keloids
  • African, Hispanic, Latin, and Asians descent
  • Pregnancy
  • Puberty
  • Blood Group A patients
  • Injuries over bones

Susceptible parts of the body to keloid scarring

  • The back of neck
  • Deltoid region of the shoulder
  • The earlobes
  • The upper arm
  • The upper back
  • The Sternum

Causes of keloid scars

Medical science has failed to prioritize on the research of this condition. There presently is an effort by leading physicians in the area of scar revision to draw more attention and to increase funding for this often disfiguring affliction. It is not fully understood why or how keloid scars occur. There does appears to be a genetic component to keloid scarring. It is known that if someone in your family has keloids then you are at increased risk Skin trauma appears to be the most common factor although they can form and there seems no apparent causation. Skin and/or muscle tension seem to contribute to keloid formation and this is demonstrated by the most common sites of their formation (the upper arm and back). However if that was the full story you would expect that other sites, such as the palm of the hand or the soles of the feet to be just as vulnerable, but this is not the case. Infection at a wound site, repeated trauma to the same area, skin tension or a foreign body in a wound can also be factors.

Additional theories regarding the causes of keloid scarring include:

  • a deficiency or an excess in melanocyte hormone (MSH)
  • decreased percentages of mature collagen
  • increased soluble collagen
  • very small blood vessels get blocked and the resulting lack of oxygen contribute to keloid formation

The absence of a clear and concise theory demonstrates the need for the medical community to place more priority on research of Keloid Scar Formation. Determining the cause will better able treatment options to improve and be more precise. The hope with a change and focus on this neglected ‘epidemic’ condition could eventually lead to a cure.