Why does keloid require a special approach?
A keloid differs from a regular hypertrophic scar in that it grows beyond the original wound and is often itchy and painful. The reason is excessive collagen production due to individual predisposition. Simple excision without further treatment results in recurrence in most patients, and the new keloid is often larger than the original one. Therefore, the operation is always complemented by a set of measures: glucocorticoid injections, silicone coatings, compression, and sometimes radiation therapy. The patient is warned about this in advance.
Why can't a scar be completely removed?
Any cut in the skin heals through the formation of a scar - this is the only way of recovery available to the body. Therefore, the task of the operation is not to “remove the scar,” but to replace a wide, retracted or deforming scar with a thin and inconspicuous one, located along the lines of skin tension.
The result depends not only on the technique, but also on the individual tendency to scarring, localization and subsequent care. Scars always form worse on the sternum, shoulders and back than on the face.
Types of scars
- normotrophic - at the skin level, the most favorable
- atrophic - retracted, below skin level
- hypertrophic - protruding, but within the boundaries of the wound
- keloid - grows beyond the wound, prone to relapse
When to operate
A fresh scar takes 6–12 months to mature: it gradually turns pale, flattens and softens. It is not advisable to operate earlier - the result may be worse than the natural result of maturation. The exception is scars that limit movement or deform facial features.