KELOIDS     What Is It?Keloids
are raised overgrowths of scar tissue that occur at the site of a skin
injury. They occur where trauma, surgery, blisters, vaccinations, acne
or body piercing have injured the skin. Less commonly, keloids may form
in places where the skin has not had a visible injury. Keloids differ
from normal mature scars in composition and size. Some people are prone
to keloid formation and may develop them in several places.    Keloids
are more common in African-Americans. They are seen most commonly on
the shoulders, upper back and chest, but they can occur anywhere. When
a keloid is associated with a skin incision or injury, the keloid scar
tissue continues to grow for a time after the original wound has
closed, becoming larger and more visible until it reaches a final size.
They generally occur between 10 and 30 years of age and affect both
sexes equally, although they may be more common among young women with
pierced ears. Keloids may form over the breastbone in people who have
had open heart surgery.     SymptomsKeloids
usually
appear in areas of previous trauma but may extend beyond the injured
area. They are shiny, smooth and rounded skin elevations that may be
pink, purple or brown. They can be doughy or firm and rubbery to the
touch, and they often feel itchy, tender or uncomfortable. They may be
unsightly. A large keloid in the skin over a joint may interfere with
joint function.    DiagnosisA
doctor diagnoses a keloid on the basis of its appearance and a history
of tissue injury, such as surgery, acne or body piercing. In rare
cases, the doctor may remove a small piece of the skin to examine under
a microscope. This is called a biopsy.    Expected DurationKeloids
may continue to grow slowly for weeks, months or years. They eventually
stop growing but do not disappear on their own. Once a keloid develops,
it is permanent unless removed or treated successfully. It is common
for keloids that have been removed or treated to return. PreventionPeople
who are prone to keloids should avoid cosmetic surgery. When surgery is
necessary in such people, doctors can take special precautions to
minimize the formation of keloids at the site of the incision. Examples
of techniques that
might be used to minimize keloid formation include covering the healing
wound with hypoallergenic paper tape for several weeks after surgery,
covering the wound with small sheets made of a silicone gel after the
surgery, or using corticosteroid injections or radiation treatments at
the site of the surgical wound at the beginning of the healing period. 
TreatmentThere
is no single treatment for keloids, and most treatments do not give
completely satisfying results. Two or more treatments may be combined.
If you decide to pursue treatment for a keloid scar, you will have the
best results if you start treatment soon after the keloid appears.
Available treatments include:   Removal with conventional surgery
— This unreliable technique requires great care, and keloids that
return after being removed may be larger than the original. Keloids
return in more than 45% of people when they are removed surgically.
Keloids are less likely to return if surgical removal is combined with
other treatments.  Dressings
— Moist wound coverings made of silicone gel sheets have been shown in
studies to reduce the size of keloids over time. This treatment is safe
and painless.  Corticosteroid injections
— Injections with triamcinolone acetonide or another corticosteroid
medicine
typically are repeated at intervals of four to six weeks. This
treatment can often reduce keloid size and irritation, but injections
are uncomfortable.  Compression
— This involves using a bandage or tape to apply continuous pressure 24
hours a day for a period of six to 12 months. Compression can cause a
keloid to become smaller. For keloids that form at the site of an ear
piercing, a clip known as a Zimmer splint usually reduces keloid size
by at least 50% after one year of compression. Zimmer splints that look
like earrings are available.  Cryosurgery
— This freezing treatment with liquid nitrogen is repeated every 20 to
30 days. It can cause a side effect of lightening the skin color, which
limits this treatment's usefulness.  Radiation therapy
— This therapy is controversial because radiation increases the risk of
cancer. Radiation treatments may reduce scar formation if they are used
soon after a surgery, during the time a surgical wound is healing.  Laser 
therapy
— This is an alternative to conventional surgery for keloid removal.
There is no good evidence that keloids are less likely to recur after
laser therapy than after regular surgery.  Experimental treatments
— One treatment showing promise is injecting keloid scars with
medicines that were developed to treat autoimmune illnesses or cancers.
Treatments with these medicines (various types of interferon and the
chemotherapy agents 5-fluorouracil and bleomycin) will need to be
evaluated further before they are appropriate for use outside of
research studies.
  When To Call a ProfessionalKeloids
are primarily a cosmetic concern. If a scar becomes enlarged, itchy,
uncomfortable, interferes with the movement of a joint or creates an
unacceptable cosmetic effect, discuss treatment options with your
doctor.    PrognosisKeloids
are harmless, cosmetic problems that do not become cancerous
(malignant). Once a keloid stops growing it usually remains stable
unless the area is injured
again.   Warning:
The reader of this article should exercise all precautionary measures
while following instructions on the home remedies from this article.
Avoid using any of these products if you are allergic to it. The
responsibility lies with the reader and not with the site or the writer.Never 
use any home remedy or other self treatment
without being advised to do so by a physician.Group [EMAIL PROTECTED] [EMAIL 
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