What is Keloid?
Keloid is an abnormal wound healing. Physiologically, wounds heal within a few weeks. With the help of the proteins called collagen, the wound becomes firmer and the resistance increases. It is the collagen that provides it. A scar occurs after the wound heals. The size of the scar is determined from the region to the region, type of injury, tension and other reasons. Keloid is characterized by an extremely large scar, this scar goes out of the wound area and cause an unpleasant image.
What Causes Keloid?
While the wound is recovered, collagen usually decreases its production after 3 weeks and the wound begins to heal. In Keloid, collagen production never stops and the wound is not healed. This collagen production continues despite the healing of the wound, this period can last for years. Keloid is usually genetic, but the exact cause is unknown. Sometimes severe injuries, severaly burned wounds, cause similar scarring, but they are different from keloid and are easier to treat. These are called hypertrophic scars and are within the limits of the original wound. Keloid goes beyond these limits.
All kinds of injuries that may occur in genetically predisposed persons (cuts due to injury, scratches, surgical incisions, needle stings, vaccinations, tattoos, earrings, piercings) may cause cancer.
As a result, keloid may occur as a result of any trauma that disrupts skin integrity.
Most vulnerable Areas
- Breast area,
- Above the joints,
Keloid formation can be seen in every part of the body. However, some people may have it one some part of the body and don’t have it at the other parts.
Since keloid is caused by uncontrolled production of collagen, collogen-suppressing drugs such as steroid can be injected into the lesion and keloid can be controlled.
Printed clothing can also reduce the keloid.
In fact, keloid can be removed and treated very easily wherever it is in the body. However, since there is wound healing disorder in the pathophysiology of keloid, collagen production is more intense after surgery and the rate of keloid reappearing greater than before surgery and is almost 100%. Therefore, after the removal of koloid tissue additional intervention is required. Steroid injection and wearing printed clothing are some of the procedures that must be performed after the surgery.
Keloid And Brachytherapy
For many years, keloid treatment has not been successful. After the surgery, the application of radiotherapy has provided successful results. However, it has always been avoided because of the carcinogenic effect of radiotherapy on the body. When radiotherapy is applied, it has a negative effect on other parts of the body except the lesion site.
In recent years, with the help of special devices which are used with the technique called brachytherapy, the radiation beam can only be used in the keloid area and in low doses.
After surgical removal of the keloid tissue, special tubes placed in the surgical area. The tubes remain in the scar area and the tip of the tubes is left outside the wound site. Within the first 8 hours after the operation, a very low dose of radiation beam is passed through the tubes. Since this beam passes through the protected area and the dose is low, it does not spread to another part of the body. It only affects the scarred area. The amount of radiation that can spread out is far below the rates that can damage the body. Depending on the size of the lesion, the dose of radiation is determined and a few more doses are completed within a few days. At the end of the treatment, the tubes are withdrawn from the surgical area.
In this process, the wound healing continues and over-production is stopped because collagen is suppressed.
Recent studies have shown that 50% to 80% of keloid patients treated with brachytherapy and keloid have not been reappeared.