Keloids and Hypertrophic Scars

A keloid is a benign, well-demarcated area of fibrous tissue overgrowth that extends beyond the original defect. A hypertrophic scar is similar but remains confined to the initial defect and tends to resolve with time. An imbalance of matrix degradation and collagen biosynthesis resulting in excess accumulation of collagen in the wound has been postulated to be the primary biochemical features of this skin lesion. Keloid and hypertrophic scars derived fibroblasts produce increased amount of collagen per cell compared with normal fibroblasts. Treatment has to be individualized depending upon the distribution size, thickness and consistency of the of the lesion and association of inflammation. Prevention is the key, but therapeutic treatment of hypertrophic scars and keloids includes a large number of options and among these options the most commonly used corticosteroid is triamcinolone acetonide. Studies have shown that up to 50% of the cases showed significant improvement with respect to scar color itching and scar elevation.