TOP > SCAR WARS -Fighting against Keloid- > Episode.01; What is keloid?/Why keloid is formed?/Keloid constitution etc...

SCAR WARS -Fighting against Keloid-

Episode.01 ケロイドとは...

1. What is keloid?

The definitions of keloid and hypertrophic scar, the latter is sometimes mistaken for keloid, are described in other home pages. So please refer to them if you want to know the definitions. Keloid is not only a problem of look; it also causes pain and itching. No drug seems effective to these symptoms. In addition, depending on the area of the body keloid can also restrict body movement. In my case the keloid was a long vertical scar in the stomach and I could not stretch my body due to the hard collagen mass of the keloid. If the keloid is in the joint area, then the joint cannot bend. It seems that currently there are no medicines to treat these kinds of conditions.
Among keloids there are conditions called "true keloid", in which collagen production does not stop and Keloid spreads continuously on skin. I myself and the doctors and researchers I met so far have not seen this kind of conditions.

Although it is said that a keloid rarely becomes malignant tumor, some keloid is said to become malignant tumor when burnt. Keloid only develops in human. Research is very hard to carry out because animals never have any keloid and animal tests can not be done. It was reported that scars from the nose part of some kind of dolphin are similar to keloid, but it was actually not true. Even if it is the case, it is impossible to do research on dolphin's nose.

Roughly speaking Keloid is mass of collagen

Collagen is one important kind of protein present in human bodies. It is said that when there is a deep wound (below two thirds of the dermis), in emergency collagen is produced in large amount to cover the wound. But if collagen is produced in such amount that is far exceeding the necessary amount, collagen lump formed far over the range of the wound is called keloid.

皮膚侵襲の深さとケロイドの発生

2. Why keloid is formed?

The reason of keloid formation is not yet understood. It is often said that if wound healing is slow, it is likely to form keloid. But there are no reliable statistic data or evidence. In my case, wound healed very fast after stomach operation, but the scar developed keloid (more precisely it was hypertrophic scar). Excessive collagen production leads to keloid. Protein production suppression with steroids prevents keloid formation. These indicate that fast wound healing (fast collagen production) may lead to keloid formation, although there is no reliable evidence.

3. Keloid constitution

Though it is said that there are people with keloid constitution, there are certainly people like me who are prone to form keloid or hypertrophic scars. Depending on races keloid formation is varied. It is said that there are very few Caucasians who develop keloid, but there are large numbers of black people who develop keloid, while Asians are in between. Though it looks like that there are some relations between skin color and keloid, many reports, which indicated that there are no relations between keloid formation and melanocyte, were published. Even among Japanese, colored skin people are not always likely to develop keloid. It seems that it is not only due to skin color difference.

I learned from my research advisor, worldly known burn healing expert, the late Dr. Hidejiro, Oya that there are more keloid people among Korean than among Japanese, though both are Asians. He presumed that is not mainly due to race difference but eating habit difference, i.e. Korean people eat a lot of garlic. Dr. Oya also mentioned that after allicin (garlic's odor source) derivative containing alimentary drug was introduced into Japan, the cases of keloid increased. Therefore, the drug was modified and allicin is not used anymore.

4. Keloid deteriorating factors

唐辛子・ニンニク・カレー

The pain and itching from keloid become worse when blood flowis increased. Therefore, things that help increase blood flow are considered not good for keloid. Examples are chili, garlic, and curry etc. in food and alcoholic drinks. In the case of myself when I had keloid, itching became very bad when I drank alcohols. Since hot bathing causes blood flow increase, it is considered as one of the deteriorating factors for keloid. It is not completely clear, though.
Dr. Oya once had a patient who was a branch manager of a bank and developed keloid on his back due to burns. Dr. Oya did not allow him to take a bath. But the branch manager liked bathing very much, so he did not follow doctor's instruction. He took hot shower everyday and sometimes bath, and his keloid became better contrary to the medical knowledge. Dr. Oya thought his keloid treatment and no bathing had ameliorated the branch manager's keloid, but the manager confessed the truth. Dr. Oya had to withdraw the medical hypothesis due to this fact. It is possible that pain and itching becoming worse and keloid deterioration i.e. further collagen production are not correlated. With the branch manager's example and the knowledge of some medical reports which revealed that the blood vessels of keloid tissue are often obstructed (blood vessels become narrower due to endothelial cell over proliferation) and blood flow may not be sufficient, I thought that blood flow increase might actually be good for keloid. So I drank alcohols and took bath everday when I had keloid, even though the itching was very bad. But actually increasing blood flow is good or not for keloid is not well understood. At least in my case, there was no feeling of keloid became worse. Keloid became much better by treatments using the medicine I developed myself. Please look forward to the next episode. In addition, it is known that keloids become worse during pregnancy and puberty. It seems that there are some relations between keloid and sexual hormones. But it seems that hormone therapy does not help keloid.

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