Mon | Nov 29, 2021

Dear Doc | Sexy gone horribly wrong

Published:Sunday | April 28, 2019 | 12:00 AM

Q Dear Doc, I need your help fast. I wanted to look sexy for the holiday weekend, so I pierced my navel, but now it’s healing with extra skin! Now I have had to remove the ring, and worse, the bulge of skin at my navel looks disgusting! That is not sexy! Could it possibly be what they call keloids, and is there anything I can do to get rid of it and fast?

A I am very sorry to hear about your piercing, but yes, that does sound like you have developed a keloid scar at your piercing, and that is actually quite a common occurrence. Unfortunately, however, there is no way to get rid of it quickly.

What is a keloid scar?

A keloid, which is sometimes also referred to as a keloid scar, is a tough heaped-up or bulging scar that rises quite abruptly above the rest of the skin. It usually has a smooth top, is irregularly shaped, and tends to enlarge progressively. Some keloids become quite large and unsightly and can be itchy, tender, or even painful to the touch. Unlike regular scars, however, keloids do not regress over time.

Keloids are caused by a defect in wound healing. They develop as a result of abnormal scar formation. I like to consider them as scars that do not know when to stop. We do not understand exactly why keloids form, but we believe that it may be caused by defects in the cell signals that control the cell proliferation and inflammation stages of wound healing.

People with darker skin are typically more likely to develop keloids – 15 times more likely to be exact. Keloids are equally common in women and men and are less common in children and the elderly. In some cases, the tendency to form keloids seems to run in families.

Keloids and piercings are very common, and they develop following minor injuries that occur with body piercing. It is impossible to predict whether a piercing will lead to keloid formation. For example, one person can develop a keloid in one earlobe after a piercing but not in the other.

Yes, keloid scars are unsightly, and many persons have asked for them to be cut out, however, just simply cutting out a keloid is likely to result in an even larger keloid developing at the site. Special techniques must be used soon after the surgical procedure to remove them completely in order to prevent the formation of a new, larger keloid.

It is unclear whether early treatment is important, but it is clear that the bigger the keloid, the more difficult it is to treat.

What are treatment options for keloids?

- Corticosteroid injections: These injections are usually given once every four to eight weeks into the keloids and usually help flatten keloids. Steroid injections are sometimes combined with anti-cancer agents for improved results. The keloid may look better after treatment than it looked at the start, but even the best results leave a mark that looks and feels quite different from the surrounding skin.

- Surgery: Because we know cutting a keloid can cause the formation of a similar or even larger keloid, better success is achieved by injecting steroids or applying compression to the wound site after cutting away the keloid.

- Laser: The pulsed-dye laser can be effective at flattening keloids. Treatment is safe and not very painful, but several treatment sessions may be needed.

- Silicone gel or sheeting: This involves wearing a sheet of silicone gel on the affected area continuously for months. Results are variable, and some doctors claim similar success with compression dressings made from materials other than silicone.

- Pressure: Special earrings are available, which, when used appropriately, can cause keloids on the earlobe to shrink significantly.

- Cryotherapy: Freezing keloids with liquid nitrogen may flatten them but often darkens or lightens the site of treatment.

- Radiation: Some doctors have reported safe and effective use of radiation to treat keloids using a variety of techniques. Superficial radiation treatment after surgical excision has also been found to be useful.

Unfortunately, there are no effective home remedies for keloids.

The best way to deal with a keloid is not to get one because current treatments leave a lot to be desired. So now that you know that you are prone to having a keloid scar, you should avoid cosmetic skin surgeries and piercings.

You should also know that the keloid will never entirely disappear with treatment, but is likely to become less symptomatic and flatter, and the larger your scar is, the more difficult it is to treat.

Speak with your family physician who may treat your keloid or refer you to a dermatologists or a plastic surgeon who can.

deardoc@gleanerjm.com