Keloids: A Review of Etiology, Prevention, and Treatment
- PMID: 32308783
- PMCID: PMC7158916
Keloids: A Review of Etiology, Prevention, and Treatment
Abstract
Keloids are abnormal scars that cause significant emotional and physical distress in patients when inadequately treated. Keloid formation is theorized to occur as a result of an imbalance between an increased synthesis of collagen and extracellular matrix and decreased degradation of these products. Inflammatory mediators- namely, transforming growth factor beta-have been proposed to influence the dysregulation of collagen remodeling in the scar healing process. Though limited, current knowledge of keloid pathophysiology has guided clinicians to explore novel therapies for keloid prevention and treatment. In addition to conducting research refining the use of common therapies, such as steroids and radiation, clinicians have evaluated the potential of anti-inflammatory and chemotherapeutic molecules to suppress keloid recurrence. Procedural focused therapies, such as cryotherapy and lasers, have also found a role in reducing keloid symptomatology. The purpose of this report is to examine the current literature and review the mechanisms of action, efficacy, and side effects of different keloid therapies. Despite the growing literature investigating reliable methods for keloid management, there are no standardized guidelines or treatment protocols supported by academic governing bodies. Stronger evidence with high-fidelity randomized clinical trials will be needed to determine the optimal therapy regimens for keloids.
Keywords: Collagen; extracellular matrix; keloid; scar.
Copyright © 2020. Matrix Medical Communications. All rights reserved.
Conflict of interest statement
FUNDING:No funding was provided for this study. DISCLOSURES:The authors have no conflicts of interest relevant to the content of this article.
References
-
- Wang PH, Huang BS, Horng HC et al. Wound healing. J Chin Med Assoc. 2018;81(2):94–101. - PubMed
-
- Eming SA. Biology of wound healing. In: Bolognia JL, Schaffer JV, Cerroni L, editors. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018. pp. 2413–2424.
-
- Chu EA, Byrne PJ, Odland RM, Goding GS., Jr. Skin flap physiology and wound healing. In: Flint PW, Haughey BH, Lund V, editors. Cummings Otolaryngology. Philadelphia, PA: W. B. Saunders; 2015. pp. 1124–1136.
-
- Ghazawi FM, Zargham R, Gilardino MS et al. Insights into the pathophysiology of hypertrophic scars and keloids: how do they differ? AdvSkin Wound Care. 2018;31(1):582–595. - PubMed
-
- Hu MS, Zielins ER, Longaker MT, Lorenz HP. Scar prevention, treatment, and revision. In: Gurtner GC, Neligan PC, editors. Plastic Surgery. Philadelphia, PA: Elsevier; 2018. pp. 196–213.
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