What are Keloids and Hypertrophic Scars?
Keloids and hypertrophic scars are types of abnormal wound healing responses that can occur in children. A
keloid is an overgrowth of scar tissue that extends beyond the original wound margins, while a
hypertrophic scar remains within the boundaries of the initial injury but is raised and thickened.
Causes and Risk Factors
These conditions are often the result of an overactive healing response.
Genetic predisposition plays a significant role, with keloids being more common in darker-skinned individuals. Other factors include the location of the injury, skin tension, and the type of trauma, such as burns, surgical incisions, or acne.
Symptoms and Identification
Keloids typically appear as raised, shiny, and sometimes itchy or painful lesions that can continue to grow over time. Hypertrophic scars, on the other hand, are raised but do not expand beyond the wound's original boundaries. Both types of scars may be red or darker than the surrounding skin in children.Diagnosis
Diagnosis is usually clinical, based on the appearance and history of the scar. Dermatologists or pediatricians may use tools like
dermatoscopy to examine the scar tissue more closely. In some cases, a biopsy might be necessary to rule out other conditions.
Treatment Options
Several treatment options are available, although they might vary in effectiveness based on the scar type and the child's individual response. These include:-
Corticosteroid injections: Often the first line of treatment, these can help reduce inflammation and flatten the scar.
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Silicone gel sheets: These are used to hydrate the scar tissue, potentially reducing its size and appearance.
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Cryotherapy: This involves freezing the scar tissue to reduce its size.
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Laser therapy: This can help to flatten keloids and reduce redness.
- Surgical removal: This is typically considered for hypertrophic scars and is often followed by adjunctive treatments to prevent recurrence.
Prevention
Preventive measures are crucial, especially for children who are prone to developing keloids or hypertrophic scars. These include:- Immediate and proper wound care: Keeping the wound clean and moist can aid in better healing.
- Avoiding unnecessary trauma: Minimize the risk of injuries that could lead to scarring.
- Use of
pressure garments: These can help flatten scars during the healing process.
Impact on Quality of Life
While these scars are generally benign, they can have a significant impact on a child's
quality of life. They can cause physical discomfort, such as itching or pain, and emotional distress due to cosmetic concerns. It's important to address both the physical and psychological aspects when treating pediatric patients.
When to Seek Medical Advice
Parents should seek medical advice if they notice any rapid changes in a scar's appearance, such as increased size, color changes, or symptoms like pain and itching. Early intervention can often result in better outcomes.
Conclusion
Understanding keloids and hypertrophic scars in pediatric patients is essential for effective management and treatment. By recognizing the risk factors, symptoms, and available treatment options, healthcare providers can help improve the quality of life for affected children.
