What is a Keloid Scar?

What is a Keloid Scar?

Keloid scars are a common skin condition often found in those of Asian and African descent. In a keloid scar, the collagen that forms in the scar is mainly type III collagen or type 1 collagen. The collagen that is supposed to be repairing the skin and replacing the scab instead overgrows in the skin to form a keloid scar. The problem is that the new scar is larger than the original scar. It may look like a big lump instead of a scar and could be rubbery in texture or look like a nodule.

Keloids are the type of scar that does not tend to improve by itself over time. This type of scar can affect the movement of the skin on and around itself, and cause pain in the process.

How Doctors Define Keloids

Scientists have different definitions as to how they explain these abnormal scars.

Here are some of their definitions:

“Keloids are protrusive claw-like scars that have a propensity to recur even after surgery.” (1)

“…a type of scarring pathology which is characterized by excess collagen deposition produced during the wound healing process.” (2)

“Keloids are benign dermal tumors that form during wound healing in genetically susceptible individuals,” according to Vanderbilt University School of Medicine professors in the Center for Human Genetics Research and Department of Medicine. (3)

“Keloid scarring is a consequence of aberrant wound healing that leads to the expansion of the scar beyond the confines of the skin injury. Keloid scars are characterized by excessive extracellular matrix disposition, prolonged proliferation of fibroblasts, increased angiogenesis, and inflammatory cell infiltration. There is no single satisfactory treatment for keloid, and it can lead to severe disfigurements and bodily dysfunction.” (4)

That’s a mouthful. What the scientists are saying is that fibroblast cells are accumulating in the scar, new blood vessels are feeding these new cells, and there’s plenty of inflammation there, too.

“… characterized by the vigorously continuous production of extracellular matrix protein and aberrant cytokine activity in the dermis.” (5)

Austrian doctors at the Dept. of Plastic and Reconstructive Surgery at Inssbruck Medical University define keloids like this: “Hypertrophic scars and keloids result from an abnormal fibrous wound healing process in which tissue repair and regeneration-regulating mechanism control is lost. Although optimal treatment of these lesions remains undefined, successful healing can be achieved only with combined multidisciplinary therapeutic regimens. (6)

Don’t let any of these medical definitions make you think there’s no hope. Stay tuned for future posts on how to get rid of keloid scars.

Have a question about keloid scars? Ask in the comments!

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(1) Ooi, B.N., and Phan, T.T. (2011). Insights gained from the reverse engineering of gene networks in keloid fibroblasts. Theor Biol Med Model, May 2;8:13.)

(2) Cobbold, C.A. The role of nitric oxide in the formation of keloid and hypertrophic lesions. (2001). Med Hypotheses, Oct;57(4):497-502.)

(3) Russell, S.B., et al (2010). Epigenetically altered wound healing in keloid fibroblasts. J Invest Dermatol Oct;130(10):2489-96.)

(4) Varmeth, S., et al. (2011). Cellular senescence as a possible mechanism for halting progression of keloid lesions, Genes Cancer, Nov; 2(11):1061-6.)

(5)  Liang, C.J., et al. (2013). Thalidomide inhibits fibronectin production in TGF-B1-treated normal and keloid fibroblasts via inhibition of the p38/Smad3 pathway. Biochem Pharmacol, Jun 1;85(11):1594-602.)

(6) Wolfram, D., Tzankov, A., Pulzl, P., and Piza-Katzzer, H. (2009). Hypertrophic scars and keloids- a review of their pathophysiology, risk factors and therapeutic management. Dermatol Surg, Feb;35(2):171-81. )

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