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Keloids and Hypertrophic Scarring

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Dermatoanthropology of Ethnic Skin and Hair

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Abstract

Keloid and hypertrophic scars are diseases of excessive dermal collagen production that occur during and beyond the wound healing process. Keloid scars most commonly occur in darkly pigmented individuals, with a heightened predisposition in adolescence, young adulthood, and pregnancy. Acne lesions and areas of high tension, such as the chest, shoulder, and back, are also at higher risk for keloid development. Unlike hypertrophic scars, keloids grow beyond the original wound borders and can unpredictably progress between periods of quiescence and rapid growth. These scars can become disfiguring, symptomatic, and psychologically devastating for patients. The mainstay of treatment is intralesional corticosteroids, although surgical excision, cryotherapy, lasers, onion extract, chemotherapy, calcium antagonists, and botulinum toxin type A have been utilized. Because complete removal of keloids with current treatment options is difficult, prevention is critical in high-risk patients. This hinges on minimization of trauma, including piercing and tattooing, and aggressive acne management. Secondary preventative options include pressure therapy, silicone sheeting, and radiation. Managing patient expectations is important prior to committing to a treatment regimen, and symptom control should always be a critical part of all treatment decisions.

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Authors and Affiliations

  1. Emory School of Medicine, 1648 Pierce Dr NE, Atlanta, GA, 30307, USA

    Shalini Thareja

  2. Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St., Suite 1600, Chicago, IL, 60611, USA

    Roopal V. Kundu

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  1. Shalini Thareja
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  2. Roopal V. Kundu
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Correspondence to Roopal V. Kundu .

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Editors and Affiliations

  1. Department of Dermatology, Center for Ethnic Skin, Boston University, Boston, Massachusetts, USA

    Neelam A. Vashi

  2. University of California, San Francisco, San Francisco, California, USA

    Howard I. Maibach

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Thareja, S., Kundu, R.V. (2017). Keloids and Hypertrophic Scarring. In: Vashi, N., Maibach, H. (eds) Dermatoanthropology of Ethnic Skin and Hair. Springer, Cham. https://doi.org/10.1007/978-3-319-53961-4_15

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  • DOI: https://doi.org/10.1007/978-3-319-53961-4_15

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