Keloid scar

Dear Dr. Jen,

My daughter has an ugly keloid scar because she scraped her knee a few months back.  We have been diligently applying contractubex for two months but it doesn’t look any different.  Is there another way to make the scar look better?  I don’t want her to be conscious of her legs when she gets older.

Fatima

Dear Fatima,

Keloids are a kind of scar that is elevated and can grow bigger than the original wound. Scar tissue forms under the skin and sometimes it can get dark in color, tough and hardened.  Unlike regular scars, keloids do not regress over time.  In fact, it can get bigger and worse in appearance.  Some keloidal scars also itch and cause discomfort to the patient.

While contractubex may work on regular scars, it will usually not work on keloids.  Injecting steroids into the keloid can bring about fast results.  Depending on how well the scar responds, some may need two or more sessions. These are spaced two to four weeks apart.

Steroid may also improve the color and toughness of the scar.  While the sheen of the scar may remain, treatment with intralesional medicine will flatten and whiten the scar, as well as remove any sensation of pain or itchiness.

Some keloids also respond to laser and cryotherapy.  You can go to your nearest PDS dermatologist, who is licensed and trained to deal with keloids. Please note that further injury such as doing surgery to the keloid will likely cause more keloids to form in the future. Best of luck!

Dear Dr. Jen,

I had a laser treatment for my syringoma two months ago.  Until now there are still red marks on the area and some have even gotten dark brown in color.  It looks worse than it did before.   Are these expected?  I went back to the doctor who did it and I was given hydrocortisone cream but now I am scared to apply anything on it.

Jewel

Dear Jewel,

Syringoma are sweat gland tumors that grow around the eyes.  They can sometimes be seen on the armpits, abdomen or scalp.  While they are relatively harmless growths on the skin, they can be annoying to look at.  It is hard to camouflage them with concealer because of the bumps.

While cautery is a popular mode of treatment, it can do a lot of damage to the surrounding skin.  Syringomas tend to be found on the deeper structure of the skin, the dermis.  Hence, for complete and proper removal of syringomas to take place, any procedure will cause injury to the dermis too. Most people form red and inflamed skin over the cauterized tissue.

Laser may be a more precise machine and can go down to the level of the syringoma without much damage to the surrounding skin. However, some people still react to the laser and form inflammation weeks after the procedure.  Hydrocortisone can be a good anti-inflammatory and may benefit you.  However, if some of the bumps still remain, you can opt to do cryotherapy, using cold liquid nitrogen instead.  A trained PDS dermatologist will usually do a test spot to see which modality you will respond best to.

Dr. Tan is a diplomate of Philippine Dermatological Society (PDS) and is affiliated with the Perpetual Succour Hospital (PSH). Information on PDS is at www.pds.org.ph. Questions or concerns regarding the skin may be sent by text to 0932 857 7070 or emailed to [email protected]; or coursed thru The Freeman – (032) 2531276, or thru PSH – (032) 2338620 and 2325929. Inquiries will be forwarded to Dr. Tan.