Horizontal Keloid
About Horizontal Keloids
Horizontal keloids are an irregular superficial spread of hypertrophic and depressed areas. These scars often have a mix of hyper- and hypopigmentation; usually a hypopigmented (lighter) central zone with hyperpigmented (darker) edges. The shape of the scar can be irregular or contractile (e.g., called ‘crab claw’ due to its appearance). A characteristic of these scars is central quiescence (where the centre of the scar appears flattened or mature). All types of keloid scar differ from hypertrophic scars because they can form outside the area of injury, they can be more raised and bumpy than hypertrophic scars.
Coping with Scars
If you have skin scarring, you're not alone. Many people have scars, and there are ways to cope with them and feel more comfortable in your own skin.
Vacuum Massage
Vacuum massage is also known as depressomassage, vacuotherapy or Endermologie®. It is a non-invasive mechanical massage technique. It is performed with a mechanical device that lifts the skin by suction and creates a skin fold which can be mobilised. In the late 1970s, Louis-Paul Guitay developed the Endermologie® system (or LPG), this uses both suction (negative pressure) and mechanised rollers to mimic manual massage. LPG can provide consistent and effective treatment in a shorter time. Treatment sessions are painless and vary from 10 minutes to longer depending on the state and size of the scar.
Surgical Scar Revision
Annually, 200 million incisions (surgical cuts) are performed worldwide. The treatment of aesthetically unacceptable scars can be challenging, although several options are available. These options vary from non-invasive options to invasive scar revision. As there are lots of options along this spectrum it is important that you seek advice for your specific concerns from a surgeon specialised in scar.
Patients often see a plastic surgeon once they have tried lots of other non-invasive options. However, sometimes there are non-invasive options that could be more appropriate than surgery; again, an assessment by your scar specialist is important.
While various surgical options exist, all surgery carries risk and therefore a full assessment is important so that you can let the surgeon know what your concerns are. The surgeon can explain all the possible procedures, the pros and cons of each one and what can or can’t be achieved with surgery. Sometimes more than one surgery will be needed and follow up after surgery is also important.
Surgical Wound Closure Techniques
The healing of cutaneous wounds after surgery is the result of a cascade of complex biochemical events that can be categorized into four overlapping phases: haemostasis, inflammation, proliferation, and remodelling. All these phases of wound healing are influenced by both intrinsic and extrinsic (inside and outside) mechanical forces which effect the tension in the skin. Evidence shows that extracellular matrix remodelling can be upset by these forces. For example, wounds over or near joints may be more likely to develop hypertrophic scars because of joint movements causing repeated tension on the wound, leading to abnormal scarring.