Who’s prone to keloids?

By Viqué-Ocean Kahinju
HILLARY was convinced by a friend to get a tattoo on his chest. But a few months down the road, his chest started to itch and swell .Not long after, a dome-shaped scar developed.

He tried several medication in vain. Doctors said he had developed keloids and would require a surgical procedure.
“Dermatologists (skin experts) diagnose keloids on the basis of appearance and history of tissue injury such as surgery, acne, body piercing or ingrown hair in the skin pores,” explains Dr. Gregory Gitahi, a dermatologist at Kampala Skin Clinicians. Rarely do doctors do a biopsy (removal a small piece of the skin to examine under a microscope).

A keloid has a smooth feel, it glitters and has a different colour from the rest of the skin because the blood circulation system is cut off.

Gitahi says keloids tend to affect more men than women. “Keloids have been mostly identified in highly dark-pigmented skin men.”

Africans are, therefore more vulnerable to keloids as opposed to whites. Sometimes children develop keloids as a result of burns or injuries. But this is quite rare.

“Nonetheless, though they are rendered dead skin, keloids grow and enlarge,” says Gitahi. “This necessitates urgent medical intervention lest the swelling overrides the entire body part. About 40% of people who have had keloid surgery complain about the scar recurrence.”

Sometimes keloids tend to have recurring abscesses, especially on the same keloid, says Dr. David Ssali, a dermatologist at Derma Medical Centre in Kampala.

However, some people are prone to keloids and may develop them in several places. It is also assumed keloids can be genetically inherited. But this often is dismissed as a myth,” says Ssali.

“It is advisable to take good care of one’s skin by paying attention to every disorder. Scars can turn out to be so dangerous. Many people have developed skin cancer or tumors as a result of minor skin inflammation.”

People have different skin types thus the diversity in skin reactions, says Dr. John Nsibambi, dermatologist at Osler Clinic in Rubaga. “Keloids typically appear, following surgery or injury, but they can also appear impulsively due to slight inflammation, such as an acne (pimple) on the chest or face.”
Symptoms

Inflammation characterised by itching, swelling and pain of areas of previous cuts, surgery or piercing, but may extend beyond the injured area.

Unstoppable expansion of a scar, causing a dome-shaped heap of tissue piles on the skin. A large keloid in the skin over a joint may interfere with joint function.

Treatment and prevention
Seek medical help as soon as you realise a scar is inflamed. Do not ignore skin abrasions and cuts. A cut that is deep enough to require stitches should be stitched promptly.

Treatment
Steroid injections are administered because they cause tissue to become thin.
A specialist injects the keloid for many weeks proceeding surgery, surgically removing the keloid material, and the wound is carefully stitched.

In developed countries, surgery of the keloid is followed by radiation therapy where patients receive surface radiation to the affected area, removing the scars.

Dos and don’ts
Pay much attention to body cuts no matter their size. Small cuts can develop into keloids.

Know your family skin history. Avoid tattoos or body piercing if you have family skin problems.
Never scratch a scar.
Seek treatment for keloids from a skin specialist.

Avoid skin jellies or lotions that have bleaching substances because they can inflame old scars.
Seek immediate medical help before a keloid expands.