What are hypertrophic keloid scars?
Scars are the visible scars that remain on the skin after an injury. Healing disorders can sometimes lead to the appearance of scars that are aesthetically unacceptable and can even cause functional disorders. The scars in this case may have a different color and texture to the healthy skin and / or be noticeable. The location, clinical appearance, size and type of scarring (hypertrophic scar or cheloid) are factors that determine how they are treated. The patient should note that the gums from a plastic surgeon improve but do not disappear.
Scar Types
Hypertrophic scars occur shortly after injury and are usually slightly affected by adjacent skin and have a strong reddish color. The keloids extend beyond the borders of the original trauma or surgical incision. They are more sour, red and itchy. The most common sites for keloids are the chest, shoulder, back and ears. Radical scarring affects limit the normal mobility of joints and their functionality. Such scars often occur after burns or wounds in the joint area.
Non-surgical treatments
-Pressive method
Pressure is used to treat scars because it is believed that the pressure suppresses neovascularization and consequently the scars are inverted. This method involves silicone sheets as well as special pressure bandages and custom-made pressure clothing.
-Steroids
The injection of cortisone (triamcinolone) injectable into the scars after 2-3 sessions at 3-4 weeks intervals usually improves their texture, resulting in discoloration and flattening. The steroids used are not absorbed by the body and the side effects are infinite.
-Laser
The Pico Laser at 532nm laser emits a red beam that is absorbed by the red color of the scars (in particular, the oxyhemoglobin in the blood vessels), resulting in their shrinkage and activation of normal regenerative mechanisms. It is therefore very important that the scars be as recent (red) as possible, in order to have the best therapeutic effect. But even in the older (white) scars, the results are quite satisfactory.
-We should note, however:
1. It takes 3-5 sessions (every 3-4 weeks) to achieve significant improvement.
2. It is not possible to predict precisely the rate of improvement that the scars will have. But in most cases the results are very satisfactory.
3. Laser therapy may be combined with other therapeutic methods (pressure, gel or silicone sheets, triamcinolone).
Surgical treatment
The simplest method involves surgical removal of the scar and immediate closure of the surgical wound with local anesthesia. The blocking is done in layers and with very thin stitches, so that the new scar is flat and as invisible as possible. Scarring if not combined with other post-operative treatment, over 50% relapse. For this reason 2-3 weeks after silicone gel, Pico laser and triamcinolone infusion are applied to reduce relapse rates. Z-plastic is a plastic surgery technique that uses a Z-type incision to reduce the scarring of a scar but also to "hide" it in a normal aspect of the skin. W-plastic is used to correct sunken or raised scars. Tissue expansion is a relatively new technique for scarring and has been shown to correct extensive scarring. Tissue expanders are silicone "balloons" that are surgically placed under the skin of the area adjacent to the scars. The "balloons" gradually fill with saline, thereby causing the skin and subcutaneous tissue to expand. When a satisfactory extension is achieved, a second surgery is performed, whereby the extensors are removed and excess skin is used to cover the scar resulting from scar removal. Skin grafts, flaps and synthetic skin substitutes offer good solutions to serious scarring problems. These surgical techniques help to resolve the functional problem and provide a satisfactory aesthetic effect.