How to get rid of keloids: Singaporean dermatologists share the causes, effects, and remedies behind the scarring

How to get rid of keloids: Singaporean dermatologists share the causes, effects, and remedies behind the scarring

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Text: Emily Heng

Image: Instagram | @behindthescars__

Scars — by their very nature — remind us that while injuries fade and wounds recover, they don't always heal perfectly. They are vestiges of hard-won battles against acne, chickenpox, and even, uh, human error (see: the time our beauty writer burned herself with her hair straightener) that are frustratingly resistant to removal. Particularly so when scar tissues experience overgrowth, causing the formation of smooth, hard lumps that envelope injury.

Say hello to keloids; a raised and ill-defined growth in the area of damaged skin. While it poses no health risk, they can be painful, itchy or cause a burning sensation. "The main concern of keloids is usually the cosmetic appearance," explains Dr Wong Soon Tee, accredited dermatologist of Assurance Skin, Laser, and Aesthetics. "Though in severe cases, keloids can even stretch across joints to cause restriction of movement." And that's not all he — and the other dermatologists we spoke to — had to say about this mysterious form of scarring. We get the dirt on the causes, effects, and remedies behind these commonly misunderstood lumps and bumps, below.

What does a keloid look like?

Keloids most often begin as a raised scar that is either pink, purple or red. It comes with a flat surface, and differs in texture based on the individual. Some are soft and doughy, while others find theirs hard and thick. Either way, it in no way affects or worsens one's health — unless they are infected, of course. "Any additional trauma or friction to the wound can quite often result in cysts and abscesses within the scar, hence leading to more discomfort and pain," says Dr Liew Hui Min dermatologist and founder of HM Liew Skin & Laser Clinic.

What causes the formation of keloids?

"Keloids are a result of abnormal and exuberant wound healing," Dr Wong elaborates. "Thus, high skin tension at the wound healing site plays a significant contributory role to keloid formation. It most often occurs following surgical and non-surgical wound healing, e.g. open-heart surgery or ear lobe piercings. However, inflammatory skin conditions such as acne, chickenpox, and vaccination reactions may also induce keloid formation."

Dr Liew adds, "There are certain individuals who are more susceptible to keloid formation. Those with darker skin (think people of Asian, Black, and Hispanic descent) and those with a family history of keloids, for instance. This is because their fibroblasts — a type of cell found in connective tissue — will produce far more collagen as compared to what is produced during normal wound healing, which can lead to keloid formation."

Where do keloids usually form?

The chest, shoulders, back of the neck, jawline, earlobes, as well as the arms and upper backs are danger areas. Keloids don't sprout up overnight, so be sure to watch out for their growth over a period of a time. Usually, most take from three months to a year to be considered 'fully' grown.

Is it possible to get rid keloids?

Yes, though it is tricky. "Surgery is generally not recommended as there is a high risk of recurrence as well as worsening of the scar," Dr Liew reports. "I would recommend repeated steroid injections instead, as this prevents overgrowth. Patients can also opt for pulsed dye lasers to reduce redness and a fractional CO2 laser to contract the scar on top of the injections. One should be aware, though, that the odds of reoccurrence are high with this method of removal." Liquid nitrogen therapy and radiation therapy are good options to consider as well, according to Dr Wong. At-home remedies, however, are not recommended as it may lead to further irritation.

Can you prevent the growth of keloids?

"Avoid any skin injuring procedures," Dr Liew advises. "I mean everything from body piercings to surgeries. If it's medically necessary, speak to your surgeon. They might suggest early prevention steps such as steroid injections as well as a topical silicon barrier gel."