Materiały źródłowe

• #1 How to prevent keloid scars

  https://www.aad.org/news/how-to-prevent-keloid-scars

  Keloids are a type of raised scar that can occur after an injury, and over time they can grow much larger than the wound itself. […] Fortunately, there are some ways people with keloid-prone skin can prevent a scar from becoming a full-blown keloid. […] Dr. Kenkare and the AAD recommend people who are prone to keloids follow these prevention tips: […] Avoid unnecessary injury to the skin if possible. Any injury to the skin, intentional or not, can cause a keloid to form. […] Practice proper wound care to reduce scarring. If you injure your skin, gently wash the area immediately with soap and water. […] Protect wounded skin from the sun. The suns damaging ultraviolet rays can make your scar darker and may slow healing. […] Use silicone sheets or gel as soon as the wound has scabbed. These products can help prevent keloids from forming and may reduce the size of existing scars. […] Pay attention to new piercings. Piercings are a very common spot where keloids form. […] People who are prone to developing keloids also should seek earlier treatment for acne to reduce the risk of scarring, said Dr. Kenkare.

• #1 Keloid scars: Self-care

  https://www.aad.org/public/diseases/a-z/keloids-self-care

  Keloids can affect your well-being. Follow these tips from board-certified dermatologists to help prevent keloids from forming. […] If you have keloid-prone skin, you cannot always prevent a keloid. By taking precautions, you may reduce your risk of getting a keloid. […] The best way to prevent a keloid is to skip getting a piercing on any part of your ears. […] If you still want to try a piercing, here’s what can help reduce your risk of developing a keloid on your ear. Pay close attention to your ears after getting a new piercing. […] At the first sign of thickening, immediately remove the earring and start wearing a pressure earring instead. […] To get the best results from a pressure earring, you must start wearing it as soon as the skin starts to thicken, and you must wear it for at least 12 (and preferably 20) hours a day for 4 to 6 months.

• #1 Keloid scars: Self-care

  https://www.aad.org/public/diseases/a-z/keloids-self-care

  The best way to prevent a keloid is to skip the body art and cosmetic procedures. […] If the skin in the test area starts to thicken, you want to start wearing a pressure garment immediately. Pressure can prevent the thickening skin from turning into a keloid. […] Tell your surgeon before the surgery that you or a blood relative develop keloids. Your surgeon may be able to take precautions that can reduce your risk of developing a keloid. […] If you notice it thickening, contact a dermatologist right away. A dermatologist may be able to prevent the thickening skin from becoming a keloid. […] Proper wound care may help prevent a keloid. […] Keeping the wound clean helps to reduce scarring. […] You want to keep wounds moist. Moisture helps to speed up wound healing. […] After the wound scabs, apply silicone gel sheets or silicone gel.

• #1 Hypertrophic Scars and Keloids: A Complete Overview — DermNet

  https://dermnetnz.org/topics/keloid-and-hypertrophic-scar

  As these often occur after trauma, the following strategies may help prevent their formation: […] Minimal tension surgery […] Eversion of wound edges during suturing […] Limit the number of sutures used […] Avoid unnecessary surgery / cosmetic procedures in keloid-prone individuals and areas.

• #1 Keloid scar – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/keloid-scar/symptoms-causes/syc-20520901

  Protect your skin from injury. Try to avoid injuring your skin. Consider not getting body piercings, tattoos and elective surgeries. Even minor injuries such as ingrown hairs, cuts and scratches can incite a keloid to grow. […] If you decide to undergo surgery, talk with your doctor about your tendency to develop keloids. Your doctor can use surgical techniques that reduce the risk of developing keloids at the surgical site. After surgery, ask your doctor about postoperative care and follow the instructions carefully.

• #1 Keloids and hypertrophic scars – UpToDate

  https://www.uptodate.com/contents/keloids-and-hypertrophic-scars/print

  Linear incisions should not run in the direction of prevailing skin tension. For example, horizontal incisions are better for the abdomen than vertical incisions because the tensile direction in this region is vertical. […] During surgery, subcutaneous/fascial tensile reduction sutures should be used. These sutures allow close approximation of the wound edges. As a result, sutures can be placed without tension in the dermis, and the wound can then be closed with equally tension-free, superficial sutures. […] After surgery, wounds and the subsequent immature scars should be fixed. A variety of materials (including paper tape and silicone sheeting) are available, and all have shown some efficacy in preventing pathologic scarring. […] It is important to educate patients about the importance of avoiding stretching of the immature scar to prevent scar inflammation and overgrowth. Patients should thus be instructed to avoid activities that may apply stretching forces to their immature scars. […] Adolescents with acne and a tendency to form keloids should seek early, appropriate acne treatment, which greatly increases the chance of scar-free healing.

• #1 Keloid scars

  https://www.nhs.uk/conditions/keloid-scars/

  You cannot prevent keloid scars, but if you are more likely to get them it’s recommended to avoid getting tattoos and piercings. […] It’s also recommended to get early treatment for acne to reduce the risk of scarring.

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  https://perfectimage.com/blogs/condition/keloid-scar?srsltid=AfmBOopsNFiuoO_MxetFJFDKg7G1rmGZJpJxtp0HR1KfaDFd-t76i00X

  Daily skin care is crucial for preventing keloid scars. Using silicone sheets or gels can help flatten and soften existing scars. Proper wound care is essential. Keeping wounds clean and moist can prevent infection and reduce scar formation. For sun protection, applying sunscreen to scars reduces pigmentation changes and helps scars fade. Gentle handling of acne-prone areas is important. Avoid picking or squeezing pimples, as this can lead to scarring. When it comes to body piercings, choosing professional, reputable places reduces the risk of complications and keloid formation. […] Small changes in daily routines can significantly impact keloid prevention. Individuals who undergo hair removal should opt for methods that minimize skin trauma, such as laser treatments instead of shaving or waxing. Eating a balanced diet that supports wound healing is beneficial. Foods rich in vitamins A and C, zinc, and protein can aid the body in repairing skin damage. Additionally, staying hydrated helps maintain skin elasticity and resilience. Stress management techniques are also vital since stress can impact skin healing. Practices like yoga, meditation, and regular exercise support overall skin health and can help prevent keloid scars.

• #1 Keloid scar – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/keloid-scar/symptoms-causes/syc-20520901

  A keloid scar isn’t harmful to your physical health, but it can cause emotional distress. Prevention or early treatment is key. […] Early treatment can help minimize growth of a keloid. Talk with a doctor soon after you notice a keloid. […] If you’re prone to developing keloids, take these preventive self-care tips: […] Practice good wound care. Keep a wound clean and moist. Gently wash the area with mild soap and water. Apply a thin layer of petrolatum jelly (Vaseline, Aquaphor) or other ointment. Reapply the ointment throughout the day as needed. Your doctor might recommend applying a pressure pad or a silicone gel pad to a wound while it’s healing. Adults need to take these preventive steps for six months after skin injury, and children up to 18 months. […] Applying pressure earrings to your earlobes after an ear piercing helps prevent keloids.

• #1 Keloids and hypertrophic scars – UpToDate

  https://www.uptodate.com/contents/keloids-and-hypertrophic-scars

  Promoting fast wound healing […] In general, it is important to promote rapid wound healing. The risk of developing a hypertrophic scar or keloid increases when the healing time is longer than three weeks. This can be achieved by keeping the wound clean and moisturized, thereby ensuring that the time to re-epithelialization is as short as possible. The wound should also be fixed (eg, with paper tape) to avoid strong tension on the wound. If a new scar shows any signs of ongoing or relapsing inflammation (eg, appearance of small indurations), topical corticosteroids that dampen the inflammation should be started as soon as possible and maintained until the induration has resolved. Steroid tape/plaster is particularly effective in this situation. […] To prevent the pathologic scarring of surgical incision wounds, several preoperative, intraoperative, and postoperative precautions should be taken. Linear incisions should not run in the direction of prevailing skin tension. For example, horizontal incisions are better for the abdomen than vertical incisions because the tensile direction in this region is vertical.

• #1 Keloid scars: Self-care

  https://www.aad.org/public/diseases/a-z/keloids-self-care

  They can help prevent a keloid. […] Protect the injured area from the sun. […] To get the protection you need, use a sunscreen that offers SPF 30 or higher, broad-spectrum protection, and water resistance. […] If you are concerned about thickening skin or an existing scar, a dermatologist can create a treatment plan tailored to your needs.

• #1 Keloid Scars: Symptoms, Causes, and Treatments

  https://www.healthline.com/health/keloids

  Keloids are often more of a cosmetic concern than a health concern. […] Treatments for keloid scarring can be difficult and are not always effective. For this reason, it’s important to try to prevent skin injuries that could lead to keloid scarring. Using pressure pads or silicone gel pads after an injury may also help prevent keloids. […] Sun exposure or tanning may discolor the scar tissue, making it slightly darker than your surrounding skin. This can make the keloid stand out more. If possible, keep the scar covered when you’re in the sun to prevent discoloration.

• #1 Keloids: A Review of Etiology, Prevention, and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7158916/

  Occlusive dressings. Silicone gel sheeting (SGS) is a commonly used occlusive dressing applied to reduce the risk of excessive scar formation. SGS is composed of a semi-occlusive silicone gel sheet combined with a durable silicone membrane. Though the prominent mechanism of action of these dressings is unclear, SGS is theorized to act via hydration and occlusion of the wound bed. Scar tissue has been shown to be more prone to transepidermal water loss, possibly reflecting decreased water barrier function of the stratum corneum. The SGS creates a moisture-retaining environment that prevents dehydration of the stratum corneum, which, in a downstream manner, limits activation of fibroblasts and subsequent collagen production. Several studies have shown that SGS can reduce the incidence of hypertrophic scarring and reduce scar volume. The use of SGS requires high levels of patient adherence since protocols often require patients to wear the SGS upwards of 12 hours per day for at least 12 months. Efficacy of SGS has primarily been demonstrated when the dressing is used as a preventative measure rather than a method of treatment. The necessary continuous application of SGS in hotter climates might induce a level of humidity that facilitates the formation of bacterial abscesses.

• #1 Keloids: A Review of Etiology, Prevention, and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7158916/

  Compressive therapy. Compression therapy is primarily used as an adjunct to surgical excision to prevent recurrence of ear keloids. The mechanisms of pressure therapy are thought to include mechanoreceptor-induced apoptosis of cells in the ECM and/or pressure-induced ischemia that alters fibroblast activity and promotes collagen degradation. Compression treatments are wide-ranging, including elastic wrap bandages, custom pressure ear molds, earrings, and magnets. Studies have shown that ear keloids treated with compression therapy postexcision have a nonrecurrence rate of 70.5 to 95 percent. Similar to occlusive dressing therapy, compression therapy has the best results if the pressure device is affixed for at least 12 hours per day for at least six months at a pressure of at least 24mmHg. If the pressure exceeds 30mmHg, the compression can potentially cause tissue necrosis.

• #1 How to get rid of keloids: Home remedies, treatment, and tips

  https://www.medicalnewstoday.com/articles/319900

  Keloids are scars that are large, raised, and dark in color. […] Preventing keloids through proper wound care and avoiding injury to the skin, such as piercings, is the best strategy for people who are prone to getting keloids. […] Though preventing keloids is not always possible, there may be a few ways to reduce the risk of getting one after a piercing: […] As such, they suggest that using non-metal earring backs could be a way to reduce the chance of getting a keloid on the back of the earlobe after a piercing. […] The authors suggested getting the piercing before 11 years of age, or avoiding ear piercing if there is a family history of keloids. […] No home remedies have been shown to get rid of keloids once they have formed. But, there are a few things that people can do at home after a skin injury to help prevent keloids from forming or minimize their appearance.

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• #1 Keloids: A Review of Etiology, Prevention, and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7158916/

  Surgical techniques. Beyond simple surgical excision, surgical management of keloids encompasses multiple novel reconstructive techniques that have demonstrated reduced rates of recurrence with treatment-resistant keloids. General recommendations for primary wound closure following complete excision include gentle handling of tissue, avoidance of wound bed tension, eversion of wound edges, meticulous approximation of wound edges, and adequate control of infection and bleeding. […] Cryotherapy. Cryotherapy involves the administration of freezing therapy to keloids to reduce scar volume and recurrence. During cryotherapy, the temperature of the keloid scar is lowered below -22C. Low temperatures have been suggested to induce vascular damage, resulting in cell anoxia, cryonecrosis, and coagulative necrosis. Histologic studies after cryotherapy have highlighted several significant changes in scar tissue structure. Posttreatment scar biopsies have demonstrated the reorganization of collagen fibers into a more compact parallel fashion comparable to classic scar and resultant dermal collagen structure.

• #1 Keloids: A Review of Etiology, Prevention, and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7158916/

  Intralesional steroids. As an accessible and efficacious keloid therapy, intralesional steroids continue to serve as a first-line treatment for many physicians. Typically, triamcinolone is injected at a concentration of either 2.5mg to 20mg for facial keloids or 20mg to 40mg for non-facial keloids. Corticosteroids act by suppressing wound inflammation mediators and fibroblast growth while increasing collagen degradation. Mechanisms by which triamcinolone alters fibroblast growth include inducing fibroblast hypoactivity by decreasing TGF- expression and reducing fibroblast density by increasing fibroblast apoptosis. Intralesional triamcinolone as a monotherapy has been shown to reduce keloid recurrence to an average of 50 percent after surgical excision and to reduce scar volume. However, the therapeutic response rate of intralesional steroid therapy is highly variable. Potential side effects of corticosteroid injection include pain with injection, skin atrophy, alteration in skin pigmentation, and the formation of telangiectasias.

• #1 Keloid and Hypertrophic Scar Treatment & Management: Medical Care, Prevention, Standard Treatments

  https://emedicine.medscape.com/article/1057599-treatment

  Prevention is the first rule in keloid therapy. Avoid performing nonessential cosmetic surgery in patients known to form keloids; however, the risk is lower among patients who have only earlobe lesions. Close all surgical wounds with minimal tension. Incisions should not cross joint spaces. Avoid making midchest incisions, and ensure that incisions follow skin creases whenever possible. […] A standardized corticosteroid therapy protocol has been shown to reduce the recurrence of keloids and hypertrophic scars after excision. Intralesional TAC injection was performed after removal of the sutures and then once every 2 weeks (total of 5 treatments). In addition, patients were instructed to apply corticosteroid ointment twice daily for 6 months to the wounds after suture removal. Only 3 (14.3%) of 21 keloids and 1 (16.7%) of 6 hypertrophic scars recurred.

• #1 Keloids: A Review of Etiology, Prevention, and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7158916/

  Topical imiquimod. Used successfully for the treatment of basal cell carcinoma and human papillomavirus-related warts, imiquimod 5% cream has shown promise as an adjuvant therapy for keloids after excision. Imiquimod is a Toll-like receptor 7 agonist that limits fibroblast production of collagen via increasing local concentrations of interferon alpha (IFN-). IFN- has been shown to decrease fibroblast activity in a dose-dependent manner, reduce glycosaminoglycan production, and increase collagenase levels. The reported recurrence rates of excised keloids with daily topical imiquimod 5% cream have ranged from 0 to 88.9 percent with a follow-up time of 20 to 24 weeks. Common side effects of imiquimod include hyperpigmentation, erythema, irritation, and secondary infections that typically resolve upon suspending therapy.

• #1 Keloids: A Review of Etiology, Prevention, and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7158916/

  Topical mitomycin C. Shown to reduce scarring after ophthalmologic, tracheal, and laryngeal surgery, mitomycin C can reduce keloid recurrence postexcision. Mitomycin C is an anti-neoplastic derivative of Streptomyces caespitosus that alkylates and cross-links DNA, inhibiting cell proliferation. Clinical treatment regimens in the literature include application of an absorbent material soaked in 1mg/mL of mitomycin C for 3 to 5 minutes with reapplication at three weeks. Studies that used mitomycin C as the only adjunctive therapy to surgical excision report recurrence rates from 0 to 33 percent at six months, though some studies have demonstrated several patients with nonrecurrence at greater than 12 months. […] Intralesional and topical 5-fluorouracil (5-FU). Primarily used as a chemotherapeutic, 5-FU is a pyrimidine analog that irreversibly inhibits thymidine synthase, leading to the disruption of DNA replication and cellular proliferation. 5-FU has been shown in-vitro to reduce fibroblast growth, induce fibroblast apoptosis, and decrease TGF–driven collagen synthesis. When used as a monotherapy for keloids, 5-FU has been reported to have a 21 to 35 percent rate of recurrence at a minimum of three months and maintain keloid volume reduction of keloids for at least six months after the last therapy session in 58 to 65 percent of patients. Several studies have consistently noted side effects of pain on injection, wound ulceration, and hyperpigmentation after intralesional 5-FU therapy.

• #1 Keloids: A Review of Etiology, Prevention, and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7158916/

  Interferons. Interferons compose a group of cytokines that mediate complex cellular interactions, including immunoregulatory, antifibrotic, and antiproliferative functions. Interferon alpha-2b and interferon gamma have been evaluated as therapeutic treatment options for keloids. Both interferon alpha-2b and interferon gamma have been shown to suppress collagen synthesis and scar contraction by fibroblasts, although the extent to which interferon action alters TGF-induced fibrosis is unclear. There is limited evidence regarding the efficacy of either interferon alpha-2b or interferon gamma compared to placebo. […] Bleomycin. Bleomycin is an glycopeptide isolate of Streptomyces verticillus that has been predominately used as a chemotherapeutic and secondarily studied as a treatment for keloids and hypertrophic scars. Regarding keloid pathology, bleomycin has been shown to suppress collagen synthesis by dermal fibroblasts, increase collagen turnover, and decrease the levels of lysyl-oxidase required for collagen maturation. There are multiple methods by which the effectiveness of bleomycin to reduce keloid burden has been studied, including tattooing, dermojet intralesional injection, and intralesional injection plus or minus in combination with electroporation therapy.

• #1 Keloids: A Review of Etiology, Prevention, and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7158916/

  Radiation therapy. Since the beginning of the 20th century, investigators have evaluated different radiation methods to identify the best protocols to treat keloids. Primarily, radiation therapy has been shown to be most effective as an adjunctive therapy to surgical excision compared to monotherapy. Though the mechanism of action of radiation therapy is not known, in-vitro studies of radiation therapy have demonstrated increased rates of premature cellular senescence of keloidal fibroblasts and decreased proliferation in a dose-dependent fashion. […] Pulsed-dye laser (PDL). PDL is a form of nonablative laser therapy that targets keloid microvasculature to improve scar appearance. The PDL was initially engineered to treat vascular lesions by adjusting the wavelength of the laser to 585nm to 600nm and specifically targeting hemoglobin and oxyhemoglobin as chromophores. With respect to keloid pathology, PDL is thought to cause microvascular damage that results in local hypoxia and decreased nutrient supply, which serves as a catalyst for several biochemical changes within the scar.

• #1 Keloids: Practice Essentials, Epidemiology, Race

  https://emedicine.medscape.com/article/1298013-overview

  The most effective time to give radiation therapy is during the first 2 weeks after excision, while fibroblasts are proliferating. […] When surgery cannot be avoided, make all attempts to minimize skin tension and secondary infection. […] The sheets can be worn for as long as 24 h/d for up to 1 year, with care to avoid contact dermatitis and skin breakdown.

• #1 Medical Treatment for Scars & Keloids | NYU Langone Health

  https://nyulangone.org/conditions/scars-keloids/treatments/medical-treatment-for-scars-keloids

  Often, superficial external beam radiotherapy is used to prevent a keloid from growing back after it has been surgically removed. Radiotherapy is typically recommended within 24 to 48 hours of surgery for the best results. […] Doctors determine whether more than one radiotherapy session is necessary based on the size of the keloid, whether you had the keloid surgically removed prior to radiotherapy, and the results of the first radiotherapy session. […] After dermabrasion, the skin may bleed. This is normal, and doctors apply antiseptic bandages to prevent infection while the skin heals. It may take 10 to 14 days for the skin to completely heal. During this time, doctors recommend using a broad-spectrum sunscreen with an SPF of 30 or above every time you are in the sun.

• #1 :: JKMS :: Journal of Korean Medical Science

  https://jkms.org/DOIx.php?id=10.3346/jkms.2014.29.6.751

  Management of incisional scar is intimately connected to stages of wound healing. […] In scar prevention, the single most important modifiable factor is wound tension during the proliferative and remodeling phases, and this is determined by the choice of incision design. […] The management of a surgical incision does not end when the sutures are removed. Surgical scar care should be continued for one year. […] Early intervention is a key to control hyperplastic response. […] Understanding these three main phases, wound healing can be optimized. Modifiable factors of incisional scar response include incision design, atraumatic handling of soft tissue, hemostasis, aseptic techniques, and tension reducing approaches in both the short and long-term postoperative setting. […] These are important aspects of wound management that must be emphasized to encourage patient participation.

• #1 Hypertrophic Scar: What Is It, Causes, Treatment

  https://my.clevelandclinic.org/health/diseases/21466-hypertrophic-scar

  If you know that you are prone to forming hypertrophic scars, you might want to avoid elective surgeries. Be sure to bring this up with your doctor during any consultation. Correction of any vitamin deficiencies such as Vitamin D prior to any elective surgery may also be helpful. […] If you have a wound injury or an incision wound following surgery, always follow the wound care instructions given to you by your doctor. These instructions will tell you how to clean and care for your wound to promote healing and prevent scarring. Let your provider know if you are prone to scarring so they can more closely follow you in case you need treatment for a hypertrophic scar. Keep your follow-up appointments so your provider can check on how well your wound is healing. […] Always contact your provider if you have any questions on wound care or healing.

• #1 Keloid Prevention Strategies to Minimise Scarring | Top Doctors

  https://www.topdoctors.co.uk/medical-articles/keloid-prevention-strategies-tips-to-minimise-the-risk-of-scarring

  Silicone gel sheets and silicone ointments create a protective barrier that helps maintain moisture and regulate collagen production at the wound site. […] Before and after surgery, consult with a specialist (such as a dermatologist or a plastic surgeon) for personalised advice on wound care and keloid prevention strategies. […] The best time to start is as soon as the wound has closed or healed sufficiently. […] After a wound has healed, monitor the area for any signs of keloid formation, such as redness, itchiness, or unusual growth. Early intervention is key to preventing keloids from becoming larger and more problematic.

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• #1 Keloid Scars: Risks, Causes, Prevention, and Treatment

  https://www.verywellhealth.com/keloid-scars-2328343

  Keloid scars are defined as abnormal scars that are hard, smooth, and grow beyond the boundary of the original skin injury. […] This article covers why keloid scars form and who is more likely to develop them. It also discusses several ways this type of scar can be treated, along with what you may be able to do to prevent them. […] Unfortunately, there is not much you can do to prevent keloid scars if your skin is prone to them. You can, however, assist the healing process by keeping any wounds clean. […] If you know you are prone to keloid scars due to previous experience or a family history of them, then you can take extra precautions to avoid wounds. Do not get piercings or tattoos. If you are going to have surgery, let your healthcare provider know that you are more susceptible to keloid scarring. […] Some healthcare providers say that all highly pigmented people should avoid tattoos and piercings, just to be on the safe side. […] If you are prone to keloids, the only way to prevent them is to avoid wounds as best as you can.

• #1 Keloid scar | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/keloid-scar?content_id=CON-20423988

  If you decide to undergo surgery, talk with your doctor about your tendency to develop keloids. Your doctor can use surgical techniques that reduce the risk of developing keloids at the surgical site. After surgery, ask your doctor about postoperative care and follow the instructions carefully. […] Care for your wound as directed. Wound care can be time-consuming, and compression dressings can be uncomfortable. Try to stick with the routine recommended by your doctor, as these steps are important to keloid prevention. […] Protect the area from re-injury. Avoid irritating the keloid with clothing or other types of friction or injury. […] Protect your skin from the sun. Sun exposure might change the color of your keloid, making it more noticeable. That change might be permanent. Before going outside, protect your skin by covering the keloid or by liberally applying sunscreen.

• #1 4 Steps to Prevent a Keloid Scar Formation | Peter Ch’ng Skin Specialist – KL, Malaysia

  https://www.peterchngskinspecialist.com/article/4-steps-prevent-keloid-scar-formation

  4 Steps to Prevent a Keloid Scar Formation […] But how do we prevent keloid scars before they are formed? […] One way is to wear a pressure garment given by a dermatologist. Wearing this as soon as you notice the thickening skin can prevent it from thickening further and forming a keloid. […] As soon as you notice the first sign of your skin thickening, immediately remove the earring and start wearing a pressure ring that you can get from a dermatologist. This will help to control the skin thickening and stop the formation of keloid scar. […] If you have, or had, or know that you have any potential of developing a keloid scar, you must tell your surgeon about it before undergoing any surgery. […] Whenever you have an injury on your skin or if you have undergone any treatments that required the cutting of your skin, it is important that you take the right care of your wound to reduce the risk of it developing into a keloid. […] Keeping your wound clean can help reduce scarring. […] Be careful not to cause any further injury to the site of the scar to prevent any reformation of the keloid.

• #1 Key Insights Into Keloid Prevention for Everyone – London Keloid Scar Clinic

  https://londonkeloidscarclinic.co.uk/key-insights-into-keloid-prevention-for-everyone/

  Regular follow-up care is essential for individuals at risk of keloid formation. […] Maintaining a scar management routine is crucial for individuals at risk of developing keloids. […] Tracking advancements in keloid research and treatments is essential for individuals concerned about the formation of these raised scars. […] Educating family and friends about keloid prevention plays a pivotal role in creating a supportive environment for individuals at risk.

• #1 Standard guidelines of care: Keloids and hypertrophic scars – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/standard-guidelines-of-care-keloids-and-hypertrophic-scars/

  Keloids and hypertrophic scars (HTS) are the result of overgrowth of fibrous tissue, following healing of a cutaneous injury, and cause morbidity. There are several treatment modalities which are useful for the management of keloids, though no single modality is completely effective. […] It is important to counsel the patient about the nature of the problem. One should realize that keloid will only improve and not disappear completely. Patients should be informed about the high recurrence rates. […] The primary goals while planning a treatment protocol should be a low recurrence rate, significant cosmetic and symptomatic improvement and minimal adverse effects. […] Intralesional steroids should be considered as the first line treatment for keloids and hypertrophic scars. […] A recommendation is made that intralesional 5-FU can be combined with surgical excision of keloids, as it prevents recurrence after excision in a majority of patients.

• #1 Keloids: A Review of Etiology, Prevention, and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7158916/

  The breadth of therapies available for the prevention and treatment of keloids is continually expanding, with encouraging recent progress from novel strategies. As clinicians become more familiar with the use of the different injectable treatments and devices described in the literature, reliable data can be gathered regarding their consistent use. Currently, there exist no standardized guidelines for keloid management endorsed by a governing academic body. The present absence of large, high-quality studies evaluating the efficacy different keloid modalities restricts the establishment of standardized guidelines for keloid management.

• #1 Standard guidelines of care: Keloids and hypertrophic scars – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/standard-guidelines-of-care-keloids-and-hypertrophic-scars/

  Postoperative pressure therapy designed to suit the individual patient needs is important to prevent the recurrences. […] The evidence available for many therapeutic modalities for keloids is poor and high quality randomized studies are not available. […] In spite of the availability of a large number of treatment modalities, keloid remains a difficult condition to treat. High recurrence rates, painful treatments, cosmetically unacceptable adverse effects remain a problem in the management of keloids.

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  https://journals.lww.com/jaaos/fulltext/2020/05150/keloid_and_hypertrophic_scar_formation,.3.aspx

  Keloid formation is a fibroproliferative disorder resulting in extensive production of extracellular matrix and collagen, but prevention and treatment is poorly understood. […] Preventive surgical closure and excision remain mainstays of treatment. […] Future work is being done to better understand the pathophysiology leading to keloid and hypertrophic scar formation in an effort to find preventive methods as compared to treatment strategies.

• #2 Keloid scar – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/keloid-scar/symptoms-causes/syc-20520901

  A keloid scar isn’t harmful to your physical health, but it can cause emotional distress. Prevention or early treatment is key. […] Early treatment can help minimize growth of a keloid. Talk with a doctor soon after you notice a keloid. […] If you’re prone to developing keloids, take these preventive self-care tips: […] Practice good wound care. Keep a wound clean and moist. Gently wash the area with mild soap and water. Apply a thin layer of petrolatum jelly (Vaseline, Aquaphor) or other ointment. Reapply the ointment throughout the day as needed. Your doctor might recommend applying a pressure pad or a silicone gel pad to a wound while it’s healing. Adults need to take these preventive steps for six months after skin injury, and children up to 18 months. […] Applying pressure earrings to your earlobes after an ear piercing helps prevent keloids.

• #2 Keloids: Prevention and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0801/p253-s1.html

  If you are more likely to get keloids, you should avoid skin injuries, ear piercing, and surgery whenever possible. […] Starting some treatments (for example, corticosteroid shots, pressure dressings) right after surgery may help to prevent keloids. […] If you get your ears pierced, you should wear pressure earrings to reduce scarring.

• #2 Keloid scars

  https://www.nhs.uk/conditions/keloid-scars/

  You cannot prevent keloid scars, but if you are more likely to get them it’s recommended to avoid getting tattoos and piercings. […] It’s also recommended to get early treatment for acne to reduce the risk of scarring.

• #2 Keloid and Hypertrophic Scar Treatment & Management: Medical Care, Prevention, Standard Treatments

  https://emedicine.medscape.com/article/1057599-treatment

  Prevention is the first rule in keloid therapy. Avoid performing nonessential cosmetic surgery in patients known to form keloids; however, the risk is lower among patients who have only earlobe lesions. Close all surgical wounds with minimal tension. Incisions should not cross joint spaces. Avoid making midchest incisions, and ensure that incisions follow skin creases whenever possible. […] A standardized corticosteroid therapy protocol has been shown to reduce the recurrence of keloids and hypertrophic scars after excision. Intralesional TAC injection was performed after removal of the sutures and then once every 2 weeks (total of 5 treatments). In addition, patients were instructed to apply corticosteroid ointment twice daily for 6 months to the wounds after suture removal. Only 3 (14.3%) of 21 keloids and 1 (16.7%) of 6 hypertrophic scars recurred.

• #2 Keloids – Harvard Health

  https://www.health.harvard.edu/a_to_z/keloids-a-to-z

  People who are prone to keloids should avoid cosmetic surgery. […] When surgery is necessary in such people, doctors can take special precautions to minimize the formation of keloids at the site of the incision. […] Examples of techniques that might be used to minimize keloid formation include covering the healing wound with hypoallergenic paper tape for several weeks after surgery, covering the wound with small sheets made of a silicone gel after the surgery, or using a topical corticosteroid at the site of the surgical wound at the beginning of the healing period.

• #2 AMERICAN ACADEMY OF DERMATOLOGY: HOW TO PREVENT KELOID SCARS

  https://www.prnewswire.com/news-releases/american-academy-of-dermatology-how-to-prevent-keloid-scars-302007894.html

  „People who are prone to developing keloids also should seek earlier treatment for acne to reduce the risk of scarring,” said Dr. Kenkare. […] A keloid won’t go away on its own, so if you have questions about a scar or notice a scar start to thicken, see a board-certified dermatologist, who can discuss treatment options.

• #2 Keloid Scar Treatments: Do They Work?

  https://www.webmd.com/skin-problems-and-treatments/what-are-treatments-for-keloid-scars

  How to Prevent Keloids […] The only surefire way to prevent a keloid scar from developing is to avoid injuries. If you know you are prone to getting keloids, you may want to avoid intentional injuries such as piercings, tattoos, or injections. […] If you do get an injury, take care of it properly: […] Keep your wound clean by washing it regularly with soap and water […] […] Use a silicone gel pad or pressure pad to reduce the risk of developing a keloid scar […] […] Follow your doctor’s instructions for wound care after any surgery or procedure. […] Use these methods for 6 months after an injury if you’re an adult, and for 18 months for a child.

• #2 Keloid scar | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/keloid-scar?content_id=CON-20423988

  If you’re prone to developing keloids, take these preventive self-care tips: […] Practice good wound care. Keep a wound clean and moist. Gently wash the area with mild soap and water. Apply a thin layer of petrolatum jelly (Vaseline, Aquaphor) or other ointment. Reapply the ointment throughout the day as needed. Your doctor might recommend applying a pressure pad or a silicone gel pad to a wound while it’s healing. Adults need to take these preventive steps for six months after skin injury, and children up to 18 months. […] Applying pressure earrings to your earlobes after an ear piercing helps prevent keloids. […] Protect your skin from injury. Try to avoid injuring your skin. Consider not getting body piercings, tattoos and elective surgeries. Even minor injuries such as ingrown hairs, cuts and scratches can incite a keloid to grow.

• #2 Keloids and hypertrophic scars – UpToDate

  https://www.uptodate.com/contents/keloids-and-hypertrophic-scars

  After surgery, wounds and the subsequent immature scars should be fixed. A variety of materials (including paper tape and silicone sheeting) are available, and all have shown some efficacy in preventing pathologic scarring. […] It is important to educate patients about the importance of avoiding stretching of the immature scar to prevent scar inflammation and overgrowth. Patients should thus be instructed to avoid activities that may apply stretching forces to their immature scars.

• #2 AMERICAN ACADEMY OF DERMATOLOGY: HOW TO PREVENT KELOID SCARS

  https://www.prnewswire.com/news-releases/american-academy-of-dermatology-how-to-prevent-keloid-scars-302007894.html

  Keloids are a type of raised scar that can occur after an injury, and over time they can grow much larger than the wound itself. […] „Fortunately, there are some ways people with keloid-prone skin can prevent a scar from becoming a full-blown keloid.” […] Dr. Kenkare and the AAD recommend people who are prone to keloids follow these prevention tips: […] Avoid unnecessary injury to the skin if possible. Any injury to the skin, intentional or not, can cause a keloid to form. […] Practice proper wound care to reduce scarring. If you injure your skin, gently wash the area immediately with soap and water. […] Protect wounded skin from the sun. The sun’s damaging ultraviolet rays can make your scar darker and may slow healing. […] Use silicone sheets or gel as soon as the wound has scabbed. These products can help prevent keloids from forming and may reduce the size of existing scars.

• #2 Keloid scar | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/keloid-scar?content_id=CON-20423988

  If you decide to undergo surgery, talk with your doctor about your tendency to develop keloids. Your doctor can use surgical techniques that reduce the risk of developing keloids at the surgical site. After surgery, ask your doctor about postoperative care and follow the instructions carefully. […] Care for your wound as directed. Wound care can be time-consuming, and compression dressings can be uncomfortable. Try to stick with the routine recommended by your doctor, as these steps are important to keloid prevention. […] Protect the area from re-injury. Avoid irritating the keloid with clothing or other types of friction or injury. […] Protect your skin from the sun. Sun exposure might change the color of your keloid, making it more noticeable. That change might be permanent. Before going outside, protect your skin by covering the keloid or by liberally applying sunscreen.

• #2 Keloid Scars: Symptoms, Causes, Prevention & Treatment

  https://resources.healthgrades.com/right-care/skin-hair-and-nails/keloid-scar

  Keloid scars can be difficult to treat. Multiple treatment approaches are usually necessary. This may include injections, laser therapy, freezing or cryotherapy, and silicone sheets. Surgical shaving is sometimes an option. Pressure dressings after surgery help reduce the risk of the scar returning. […] If you are prone to keloid scarring, using pressure dressings on wounds may help prevent scars from developing. […] There are steps you can take to help prevent keloid scars. You may be able to lower your risk of developing a keloid scar by: […] Avoiding piercings and tattoos. If you notice the skin thickening around an ear piercing, wear a pressure earring. Using this device for up to six months may prevent a keloid scar if you start it soon enough. […] Protecting bites, cuts, and other wounds from the sun with bandages or clothing while the wound heals. After healing, use SPF 30 or higher sunscreen daily.

• #2 Keloids: A Review of Etiology, Prevention, and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7158916/

  Occlusive dressings. Silicone gel sheeting (SGS) is a commonly used occlusive dressing applied to reduce the risk of excessive scar formation. SGS is composed of a semi-occlusive silicone gel sheet combined with a durable silicone membrane. Though the prominent mechanism of action of these dressings is unclear, SGS is theorized to act via hydration and occlusion of the wound bed. Scar tissue has been shown to be more prone to transepidermal water loss, possibly reflecting decreased water barrier function of the stratum corneum. The SGS creates a moisture-retaining environment that prevents dehydration of the stratum corneum, which, in a downstream manner, limits activation of fibroblasts and subsequent collagen production. Several studies have shown that SGS can reduce the incidence of hypertrophic scarring and reduce scar volume. The use of SGS requires high levels of patient adherence since protocols often require patients to wear the SGS upwards of 12 hours per day for at least 12 months. Efficacy of SGS has primarily been demonstrated when the dressing is used as a preventative measure rather than a method of treatment. The necessary continuous application of SGS in hotter climates might induce a level of humidity that facilitates the formation of bacterial abscesses.

• #2 Keloid scars: Self-care

  https://www.aad.org/public/diseases/a-z/keloids-self-care

  The best way to prevent a keloid is to skip the body art and cosmetic procedures. […] If the skin in the test area starts to thicken, you want to start wearing a pressure garment immediately. Pressure can prevent the thickening skin from turning into a keloid. […] Tell your surgeon before the surgery that you or a blood relative develop keloids. Your surgeon may be able to take precautions that can reduce your risk of developing a keloid. […] If you notice it thickening, contact a dermatologist right away. A dermatologist may be able to prevent the thickening skin from becoming a keloid. […] Proper wound care may help prevent a keloid. […] Keeping the wound clean helps to reduce scarring. […] You want to keep wounds moist. Moisture helps to speed up wound healing. […] After the wound scabs, apply silicone gel sheets or silicone gel.

• #2 Keloids: A Review of Etiology, Prevention, and Treatment | JCAD – The Journal of Clinical and Aesthetic Dermatology

  https://jcadonline.com/keloids-scars-treatment-review/

  Occlusive dressings. Silicone gel sheeting (SGS) is a commonly used occlusive dressing applied to reduce the risk of excessive scar formation. SGS is composed of a semi-occlusive silicone gel sheet combined with a durable silicone membrane. Though the prominent mechanism of action of these dressings is unclear, SGS is theorized to act via hydration and occlusion of the wound bed. […] The use of SGS requires high levels of patient adherence since protocols often require patients to wear the SGS upwards of 12 hours per day for at least 12 months. Efficacy of SGS has primarily been demonstrated when the dressing is used as a preventative measure rather than a method of treatment. […] Compressive therapy. Compression therapy is primarily used as an adjunct to surgical excision to prevent recurrence of ear keloids. The mechanisms of pressure therapy are thought to include mechanoreceptor-induced apoptosis of cells in the ECM and/or pressure-induced ischemia that alters fibroblast activity and promotes collagen degradation. Studies have shown that ear keloids treated with compression therapy postexcision have a nonrecurrence rate of 70.5 to 95 percent. […] Similar to occlusive dressing therapy, compression therapy has the best results if the pressure device is affixed for at least 12 hours per day for at least six months at a pressure of at least 24mmHg.

• #2 Recent Understandings of Biology, Prophylaxis and Treatment Strategies for Hypertrophic Scars and Keloids

  https://www.mdpi.com/1422-0067/19/3/711

  Silicone sheeting is recommended for use from two weeks after primary wound treatment for more than 12 h a day for at least two months. […] Flavonoids (or bioflavonoids) are naturally-derived substances from various plants and have been used for preventing severe scar formation. […] The efficacy of flavonoid scar gels like Contractubex Gel or Mederma Skin Care Gel is controversial, but other flavonoids like quercetin exert antifibrotic actions. […] Cutaneous wound compression has been used not only for prevention, but also for treatment of hypertrophic scars and keloids. […] The suggested mechanisms underlying pressure therapy include occlusion of blood vessels and limiting the delivery of inflammatory cytokines, nutrients and oxygen from blood vessels to scar tissue. […] The current treatment strategies for hypertrophic scars and keloids are listed below and summarized in Table 1.

• #2 Keloid scars: Self-care

  https://www.aad.org/public/diseases/a-z/keloids-self-care

  Keloids can affect your well-being. Follow these tips from board-certified dermatologists to help prevent keloids from forming. […] If you have keloid-prone skin, you cannot always prevent a keloid. By taking precautions, you may reduce your risk of getting a keloid. […] The best way to prevent a keloid is to skip getting a piercing on any part of your ears. […] If you still want to try a piercing, here’s what can help reduce your risk of developing a keloid on your ear. Pay close attention to your ears after getting a new piercing. […] At the first sign of thickening, immediately remove the earring and start wearing a pressure earring instead. […] To get the best results from a pressure earring, you must start wearing it as soon as the skin starts to thicken, and you must wear it for at least 12 (and preferably 20) hours a day for 4 to 6 months.

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• #2 Keloids: A Review of Etiology, Prevention, and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7158916/

  Surgical techniques. Beyond simple surgical excision, surgical management of keloids encompasses multiple novel reconstructive techniques that have demonstrated reduced rates of recurrence with treatment-resistant keloids. General recommendations for primary wound closure following complete excision include gentle handling of tissue, avoidance of wound bed tension, eversion of wound edges, meticulous approximation of wound edges, and adequate control of infection and bleeding. […] Cryotherapy. Cryotherapy involves the administration of freezing therapy to keloids to reduce scar volume and recurrence. During cryotherapy, the temperature of the keloid scar is lowered below -22C. Low temperatures have been suggested to induce vascular damage, resulting in cell anoxia, cryonecrosis, and coagulative necrosis. Histologic studies after cryotherapy have highlighted several significant changes in scar tissue structure. Posttreatment scar biopsies have demonstrated the reorganization of collagen fibers into a more compact parallel fashion comparable to classic scar and resultant dermal collagen structure.

• #2 Keloids and hypertrophic scars – UpToDate

  https://www.uptodate.com/contents/keloids-and-hypertrophic-scars/print

  Linear incisions should not run in the direction of prevailing skin tension. For example, horizontal incisions are better for the abdomen than vertical incisions because the tensile direction in this region is vertical. […] During surgery, subcutaneous/fascial tensile reduction sutures should be used. These sutures allow close approximation of the wound edges. As a result, sutures can be placed without tension in the dermis, and the wound can then be closed with equally tension-free, superficial sutures. […] After surgery, wounds and the subsequent immature scars should be fixed. A variety of materials (including paper tape and silicone sheeting) are available, and all have shown some efficacy in preventing pathologic scarring. […] It is important to educate patients about the importance of avoiding stretching of the immature scar to prevent scar inflammation and overgrowth. Patients should thus be instructed to avoid activities that may apply stretching forces to their immature scars. […] Adolescents with acne and a tendency to form keloids should seek early, appropriate acne treatment, which greatly increases the chance of scar-free healing.

• #2 Keloids: A Review of Etiology, Prevention, and Treatment | JCAD – The Journal of Clinical and Aesthetic Dermatology

  https://jcadonline.com/keloids-scars-treatment-review/

  Bleomycin. Bleomycin is an glycopeptide isolate of Streptomyces verticillus that has been predominately used as a chemotherapeutic and secondarily studied as a treatment for keloids and hypertrophic scars. […] Recurrence rates after using bleomycin tattooing range from 14 to 28.6 percent at between 10 to 18 months posttreatment. […] Surgical techniques. Beyond simple surgical excision, surgical management of keloids encompasses multiple novel reconstructive techniques that have demonstrated reduced rates of recurrence with treatment-resistant keloids. […] General recommendations for primary wound closure following complete excision include gentle handling of tissue, avoidance of wound bed tension, eversion of wound edges, meticulous approximation of wound edges, and adequate control of infection and bleeding.

• #2 Keloids: A Review of Etiology, Prevention, and Treatment | JCAD – The Journal of Clinical and Aesthetic Dermatology

  https://jcadonline.com/keloids-scars-treatment-review/

  Intralesional steroids. As an accessible and efficacious keloid therapy, intralesional steroids continue to serve as a first-line treatment for many physicians. […] Intralesional triamcinolone as a monotherapy has been shown to reduce keloid recurrence to an average of 50 percent after surgical excision and to reduce scar volume. […] Topical imiquimod. Used successfully for the treatment of basal cell carcinoma and human papillomavirus-related warts, imiquimod 5% cream has shown promise as an adjuvant therapy for keloids after excision. […] The reported recurrence rates of excised keloids with daily topical imiquimod 5% cream have ranged from 0 to 88.9 percent with a follow-up time of 20 to 24 weeks. […] Topical mitomycin C. Shown to reduce scarring after ophthalmologic, tracheal, and laryngeal surgery, mitomycin C can reduce keloid recurrence postexcision. […] Studies that used mitomycin C as the only adjunctive therapy to surgical excision report recurrence rates from 0 to 33 percent at six months.

• #2 Keloids – UF Health

  https://ufhealth.org/conditions-and-treatments/keloids

  When you are in the sun: […] Cover a keloid that is forming with a patch or adhesive bandage. […] Use sunblock. […] Continue to follow these steps for at least 6 months after injury or surgery for adults. Children may need up to 18 months of prevention. […] Imiquimod cream may help prevent keloids from forming after surgery. The cream may also prevent keloids from returning after they are removed.

• #2 Hypertrophic Scars and Keloids – Medical Clinical Policy Bulletins | Aetna

  https://www.aetna.com/cpb/medical/data/300_399/0389.html

  Several clinical trials have demonstrated the effectiveness of intralesional 5-fluorouracil in the treatment of keloid scarring. […] The authors concluded that the findings of this study showed that CO2-AFL was a safe and effective treatment modality for burn scars; improving thickness, symptoms and QOL of burn survivors when compared to conventional scar treatment. […] The authors concluded that the findings of this study showed that 1,470-nm fiber laser treatment could improve inflamed keloids fairly well by decreasing inflammation, and a relative stabilization of collagen composition. […] The authors concluded that the findings of this study indicated that MAIT cells could be associated with keloids and may serve as potential biomarkers or therapeutic targets in the diagnosis of keloids. […] The authors concluded that the findings of this study demonstrated that HBOT decreased the recurrence rate of pathological scars following surgery and radiotherapy, increased patient satisfaction, and reduced the VSS score; therefore, providing a new way to treat pathological scar hyperplasia.

• #2 Keloids: A Review of Etiology, Prevention, and Treatment | JCAD – The Journal of Clinical and Aesthetic Dermatology

  https://jcadonline.com/keloids-scars-treatment-review/

  Intralesional and topical 5-fluorouracil (5-FU). Primarily used as a chemotherapeutic, 5-FU is a pyrimidine analog that irreversibly inhibits thymidine synthase, leading to the disruption of DNA replication and cellular proliferation. […] When used as a monotherapy for keloids, 5-FU has been reported to have a 21 to 35 percent rate of recurrence at a minimum of three months and maintain keloid volume reduction of keloids for at least six months after the last therapy session in 58 to 65 percent of patients. […] Interferons. Interferons compose a group of cytokines that mediate complex cellular interactions, including immunoregulatory, antifibrotic, and antiproliferative functions. […] There is limited evidence regarding the efficacy of either interferon alpha-2b or interferon gamma compared to placebo.

• #2 Keloids: A Review of Etiology, Prevention, and Treatment | JCAD – The Journal of Clinical and Aesthetic Dermatology

  https://jcadonline.com/keloids-scars-treatment-review/

  Cryotherapy. Cryotherapy involves the administration of freezing therapy to keloids to reduce scar volume and recurrence. […] Studies have reported that intralesional cryotherapy can reduce keloid volume by an average of 51.4 to 67.4 percent at 12 months after the last treatment. […] Radiation therapy. Since the beginning of the 20th century, investigators have evaluated different radiation methods to identify the best protocols to treat keloids. […] Though numerous studies have been conducted for radiation treatment of keloids, there is still no consensus regarding overall dosage and fractionation. […] Pulsed-dye laser (PDL). PDL is a form of nonablative laser therapy that targets keloid microvasculature to improve scar appearance. […] There is no current data to determine how PDL therapy influences the recurrence of keloid scars, though there is evidence that PDL therapy, in some cases, can cause scar recurrence.

• #2 Keloid scar – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/keloid-scar/diagnosis-treatment/drc-20520902

  Wound care can be time-consuming, and compression dressings can be uncomfortable. Try to stick with the routine recommended by your doctor, as these steps are important to keloid prevention. […] How can I reduce the risk of developing a keloid? […] What self-care steps might prevent a keloid from coming back?

• #2 Keloid Prevention Strategies to Minimise Scarring | Top Doctors

  https://www.topdoctors.co.uk/medical-articles/keloid-prevention-strategies-tips-to-minimise-the-risk-of-scarring

  Silicone gel sheets and silicone ointments create a protective barrier that helps maintain moisture and regulate collagen production at the wound site. […] Before and after surgery, consult with a specialist (such as a dermatologist or a plastic surgeon) for personalised advice on wound care and keloid prevention strategies. […] The best time to start is as soon as the wound has closed or healed sufficiently. […] After a wound has healed, monitor the area for any signs of keloid formation, such as redness, itchiness, or unusual growth. Early intervention is key to preventing keloids from becoming larger and more problematic.

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• #2 How to get rid of keloids: Home remedies, treatment, and tips

  https://www.medicalnewstoday.com/articles/319900

  Keloids are scars that are large, raised, and dark in color. […] Preventing keloids through proper wound care and avoiding injury to the skin, such as piercings, is the best strategy for people who are prone to getting keloids. […] Though preventing keloids is not always possible, there may be a few ways to reduce the risk of getting one after a piercing: […] As such, they suggest that using non-metal earring backs could be a way to reduce the chance of getting a keloid on the back of the earlobe after a piercing. […] The authors suggested getting the piercing before 11 years of age, or avoiding ear piercing if there is a family history of keloids. […] No home remedies have been shown to get rid of keloids once they have formed. But, there are a few things that people can do at home after a skin injury to help prevent keloids from forming or minimize their appearance.

• #2 4 Steps to Prevent a Keloid Scar Formation | Peter Ch’ng Skin Specialist – KL, Malaysia

  https://www.peterchngskinspecialist.com/article/4-steps-prevent-keloid-scar-formation

  4 Steps to Prevent a Keloid Scar Formation […] But how do we prevent keloid scars before they are formed? […] One way is to wear a pressure garment given by a dermatologist. Wearing this as soon as you notice the thickening skin can prevent it from thickening further and forming a keloid. […] As soon as you notice the first sign of your skin thickening, immediately remove the earring and start wearing a pressure ring that you can get from a dermatologist. This will help to control the skin thickening and stop the formation of keloid scar. […] If you have, or had, or know that you have any potential of developing a keloid scar, you must tell your surgeon about it before undergoing any surgery. […] Whenever you have an injury on your skin or if you have undergone any treatments that required the cutting of your skin, it is important that you take the right care of your wound to reduce the risk of it developing into a keloid. […] Keeping your wound clean can help reduce scarring. […] Be careful not to cause any further injury to the site of the scar to prevent any reformation of the keloid.

• #2 Key Insights Into Keloid Prevention for Everyone – London Keloid Scar Clinic

  https://londonkeloidscarclinic.co.uk/key-insights-into-keloid-prevention-for-everyone/

  Many individuals underestimate the risk of keloids following body piercing, especially in the earlobe area. This blog post will provide essential insights into keloid prevention, including effective strategies and natural remedies to support your skin’s health. […] Proper wound care is essential for preventing keloids, especially after injuries or surgeries. […] Genetic predisposition increases the likelihood of developing keloids; knowledge can help in prevention. […] Adherence to proper wound care practices is vital in preventing keloids after surgery or injury. Keeping the wound clean and avoiding unnecessary tension on the incision site can significantly reduce collagen overproduction. […] Protective measures, such as the use of silicone sheets or Vaseline on healing wounds, can also assist in minimising scar formation.

• #2 Strategies for Minimizing Keloid Formation

  https://www.thewoundpros.com/post/strategies-for-minimizing-keloid-formation

  Proper scar care techniques, including gentle cleansing and moisturizing, promote optimal wound healing. […] Applying consistent pressure to the healing wound through pressure therapy helps flatten keloids and reduce their prominence. […] Silicone gel sheets have shown efficacy in preventing and treating keloids by maintaining a favorable environment for healing. […] When employed collectively or per individual requirements, these prevention strategies contribute to minimizing keloid formation. Tailoring these interventions to specific risk factors and promptly addressing wounds and injuries are integral to an effective prevention plan.

• #2 Standard guidelines of care: Keloids and hypertrophic scars – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/standard-guidelines-of-care-keloids-and-hypertrophic-scars/

  Keloids and hypertrophic scars (HTS) are the result of overgrowth of fibrous tissue, following healing of a cutaneous injury, and cause morbidity. There are several treatment modalities which are useful for the management of keloids, though no single modality is completely effective. […] It is important to counsel the patient about the nature of the problem. One should realize that keloid will only improve and not disappear completely. Patients should be informed about the high recurrence rates. […] The primary goals while planning a treatment protocol should be a low recurrence rate, significant cosmetic and symptomatic improvement and minimal adverse effects. […] Intralesional steroids should be considered as the first line treatment for keloids and hypertrophic scars. […] A recommendation is made that intralesional 5-FU can be combined with surgical excision of keloids, as it prevents recurrence after excision in a majority of patients.

• #2 Standard guidelines of care: Keloids and hypertrophic scars – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/standard-guidelines-of-care-keloids-and-hypertrophic-scars/

  Postoperative pressure therapy designed to suit the individual patient needs is important to prevent the recurrences. […] The evidence available for many therapeutic modalities for keloids is poor and high quality randomized studies are not available. […] In spite of the availability of a large number of treatment modalities, keloid remains a difficult condition to treat. High recurrence rates, painful treatments, cosmetically unacceptable adverse effects remain a problem in the management of keloids.

• #2 Erase the trace: New frontiers in scar prevention and skin repair | EurekAlert!

  https://www.eurekalert.org/news-releases/1065158

  Disruptions during wound healing phases (inflammation, proliferation, and remodeling) can result in scar formation. […] Current treatments for scars include pressure garments, corticosteroids, laser therapy, and scar excision. […] New therapies that have the potential to reduce scar formation through skin regeneration were explored, in an effort to prevent scarring in the future. […] It is important to moisturize and maintain a clean environment for preventing both types of scars. […] Some of the most common treatments for keloids include surgical excision and steroids applied directly into the skin lesion. […] By balancing the usage of VEGF inhibitors and administration of a growth factor called TGF-3, it is possible to improve scarring and promote skin regeneration.

• #3 Keloid scar – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/keloid-scar/diagnosis-treatment/drc-20520902

  Wound care can be time-consuming, and compression dressings can be uncomfortable. Try to stick with the routine recommended by your doctor, as these steps are important to keloid prevention. […] How can I reduce the risk of developing a keloid? […] What self-care steps might prevent a keloid from coming back?

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