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How to manage keloids and could they turn cancerous?

Thursday, 17 July 2003
Answered by: Rishi Parashar
Consultant Dermatologist
Sir Ganga Ram Hospital
New Delhi
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Q. I had a keloid infection which was controlled after taking phexin 250 gm tablets 4 times daily for 14 days. Is there any chances of infection in future? What is the preventive treatment and for itching and contraction what is possible? Is there any possibility keloid turning cancerous?

A.  First of all the term keloid infection is inaccurate, what you might mean is that you have an itchy scar which is slightly elevated which we medically call keloid. Occasionally scars enlarge spontaneously to form firm, smooth, hard growths called keloids. Keloids may be uncomfortable or itchy, and may be much larger than the original wound. It is not known why keloids appear. While most people never form keloids, others develop them after minor injuries, even insect bites or pimples. Keloids may form on any part of the body, although the upper chest and shoulders are especially prone to them. Dark skinned people form keloids more easily than whites. Once keloids form they stay permanently at the same site & they can be infected only if the patient scratches them till there is bleeding or they get exposed after injuries. So chances of reinfection are remote till any one of the above 2 scenarios takes place. Chances of cancer developing, though documented, are extremely rare - practically nil. The treatment modalities available are: - Corticosteroid injection, repeated every few weeks (practical) - Cryotherapy (practical) - Pressure dressings (practical) - Silicone gel dressings (practical) - Self-adhesive polyurethane scar reduction patches - Pulsed dye laser (Costly!) - Surgical excision (but may result in a second keloid even larger than the original one) - should not be done!

A.  First of all the term keloid infection is inaccurate, what you might mean is that you have an itchy scar which is slightly elevated which we medically call keloid. Occasionally scars enlarge spontaneously to form firm, smooth, hard growths called keloids. Keloids may be uncomfortable or itchy, and may be much larger than the original wound. It is not known why keloids appear. While most people never form keloids, others develop them after minor injuries, even insect bites or pimples. Keloids may form on any part of the body, although the upper chest and shoulders are especially prone to them. Dark skinned people form keloids more easily than whites. Once keloids form they stay permanently at the same site & they can be infected only if the patient scratches them till there is bleeding or they get exposed after injuries. So chances of reinfection are remote till any one of the above 2 scenarios takes place. Chances of cancer developing, though documented, are extremely rare - practically nil. The treatment modalities available are: - Corticosteroid injection, repeated every few weeks (practical) - Cryotherapy (practical) - Pressure dressings (practical) - Silicone gel dressings (practical) - Self-adhesive polyurethane scar reduction patches - Pulsed dye laser (Costly!) - Surgical excision (but may result in a second keloid even larger than the original one) - should not be done!

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