Having worked in the beauty business for the last four years has allowed me the opportunity to meet and converse with so many beauty professionals nationwide.

I was recently enlightened by a board certified plastic and reconstructive surgeon from the Greater San Diego area, Dr. John G. Apostolides.

We had  brief  Q&A about a couple of things; I mainly picked his brain about Keloids and why women of multicultural descent are more prone to developing them post surgery, compared to those of European descent.

My exact question was:

“Why is it that women with heavily pigmented complexions are more prone to keloid scarring than those of European descent?”

His insight:

“Keloids are much more common in women and men of multicultural descent. Although even in those patients, true keloids are rare. Most people of multicultural descent who think they have “Keloids” actually have hypertrophic scars, which are just scars that are somewhat thicker and more raised. Keloids are scars that actually grow beyond the borders of the initial incision or injury. There are many reasons for the difference in scarring, many causes are not known. One main reason is the inner layer of skin, the dermis, in people of multicultural descent is thicker. This causes them to heal with more scar tissue. The downside is increased chance of thicker scars, although the majority of people heal normally. The upside is the thicker skin allows them to age “less” or more gracefully due to more resilient and elastic skin.”

The last sentence is a bit enlightening. If you read the entire paragraph, take note that he said “… thicker skin allows them to age “less” or more gracefully due to more resilient and elastic skin.” That’s right! You’ve heard the saying, “Minority women age more  gracefully” Yep, it’s true.

Back on track. Now, an overview…

A keloid is the term given to the prominent, irregular scar tissue, which sometimes forms after a person has suffered some sort of trauma to the skin. Usually, a “bump” appears at the site of the injury, after surgery or from another form of scarring taken place, such as a piercing.

A keloid can also develop without injury to the skin. It is definitely more common in African Americans than any other nationality, however Indians and Chinese develop keloids as well, just not as often and with thinner scarring.

Prevention, Prevention, Prevention!

One of the most important things someone can do to prevent the formation of keloids is to properly care for skin abrasions and cuts. It’s important to remember that any cut that is deep enough, requires stitches and should be stitched promptly. Many people will put a dressing over the cut and allow it to remain open. In these cases, a keloid is likely to develop  or become infected. It is important for doctors to carefully suture the wound and to avoid damage to the surrounding skin in the suturing process.

Treatment

Keloids are never life threatening. Rather, they are considered cosmetic. One’s appearance is important, however, and keloids are problematic from this perspective.

The treatment of keloids will vary. Some people believe that if the keloid is cut out all will be fine. Many times, however, the keloid will return larger than it was before. Doctors have, therefore, developed several ways to treat keloids:

1. Injection of the keloid with steroid solutions. Steroids have the effect of causing tissues to become atrophic (thin). This is a known side effect of steroids that we are using to our advantage when we inject the keloids with the steroid solution.

2. Surgery of the keloid with use of steroid injections. In this case, we still inject the keloid for several weeks prior to the surgery. Then, we surgically remove the keloid material and the wound is carefully sutured. Steroids are again injected and continued for several weeks thereafter.

3. Surgery of the keloid followed by radiation therapy. In this case, patients receive superficial radiation to the affected area. This may be a good option in some cases.

4. Lately, there has been the development of pressure to treat keloids. Scientists have developed a type of sheeting called silastic gel which is applied to the keloid and kept in place with tape. The silastic gel is applied at night for several months and it flattens the keloid.

5. Additionally, a newer therapy involving tape impregnated with steroids has been used. The tape is applied to the keloid and the steroid is slowly released. Overtime, the keloid thins.

Empowerment Points

• Keloids are very common in Black people throughout the world.
• Keloids usually occur after a person has suffered a cut or scratch to the skin.
• The resulting scar tissue is thickened and often unsightly.
• There are a variety of treatment options available and your dermatologist will be happy to discuss them with you.

Treating keloids can be challenging, but good results can be obtained!