Keloids & Hypertrophic Scars: Best Homeopathic Remedies & Treatments

Keloids and hypertrophic scars are abnormal fibrous tissue overgrowths resulting from excessive collagen deposition during wound healing. While hypertrophic scars remain within the wound boundary, keloids extend beyond the original wound site.

Incidence

• More common in dark-skinned individuals (African, Asian descent).
• Higher risk in young adults (10-30 years old).
• Frequently occur after burns, surgeries, acne, ear piercings, and trauma.

Definition

• Keloid: A raised, thick, and progressively enlarging scar that extends beyond the original wound margins.
• Hypertrophic Scar: A thickened, raised scar that remains within the wound boundary and may regress over time.

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Etiology (Causes & Risk Factors)

1. Risk Factors (Mnemonic: SCARRED)

• S – Skin trauma (surgery, burns, lacerations).
• C – Chronic inflammation (acne, insect bites).
• A – African or Asian ethnicity (genetic predisposition).
• R – Recurrent injuries or surgical incisions.
• R – Radiation exposure (may trigger fibrosis).
• E – Ear piercing, tattoos.
• D – Delayed wound healing (infections, diabetes).

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Pathogenesis of Keloids & Hypertrophic Scars (Mnemonic: "EXCESS")

1. E – Excessive fibroblast activation.
2. X – X-tra collagen deposition (Type I & III).
3. C – Chronic inflammation persists.
4. E – Extended growth beyond wound edges (Keloids).
5. S – Scar remains elevated and thick.
6. S – Skin remodeling is ineffective.

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Clinical Features (Mnemonic: RAISED)

1. Keloids

• R – Raised, firm, nodular overgrowth.
• A – Appears beyond the original wound site.
• I – Itchy, painful, and sensitive.
• S – Slow, progressive enlargement.
• E – Erythematous (red/pink in early stage, dark later).
• D – Disfigurement, common on chest, shoulders, earlobes.

2. Hypertrophic Scars

• Thickened scar, but remains within the wound boundary.
• Reddish or pink in early stages.
• May improve over time (unlike keloids).
• Less symptomatic than keloids (less pain/itching).

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Complications

• Cosmetic disfigurement (common in keloids).
• Persistent pain and itching.
• Restriction of movement (if over joints).
• Recurrent growth after surgical removal.

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Laboratory Investigations

1. Clinical Examination – Diagnosis is based on appearance.
2. Histopathology – Dense collagen bundles, disorganized fibroblasts (for atypical cases).
3. Dermoscopy – Helps differentiate from tumors or dermatological conditions.

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Management of Keloids & Hypertrophic Scars

General Measures (Mnemonic: "NO SCARS")

1. N – No unnecessary skin trauma (avoid tattoos, piercings).
2. O – Ointments (silicone gel, onion extract) help soften scars.
3. S – Sun protection (prevents hyperpigmentation).
4. C – Compression therapy (silicone sheets, pressure dressings).
5. A – Avoid surgical excision unless necessary (high recurrence risk).
6. R – Radiation therapy for recurrent keloids.
7. S – Steroid injections (reduce inflammation and fibrosis).

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Allopathic Treatment (Mnemonic: "SILICON")

1. S – Steroid injections (Triamcinolone) – First-line treatment.
2. I – Imiquimod cream – Helps prevent recurrence post-excision.
3. L – Laser therapy – Reduces redness and thickness.
4. I – Interferon therapy – Slows fibroblast activity.
5. C – Cryotherapy – Freezing helps reduce size.
6. O – Onion extract gels (e.g., Mederma) – Soften scars.
7. N – Non-invasive pressure therapy (silicone sheets).

Surgical Treatment

• Surgical excision – High recurrence risk (50-100%) if not combined with other therapies.
• Cryosurgery – Best for small keloids.
• Radiotherapy – For recurrent, resistant keloids.

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Homeopathic Treatment

1. Thiosinaminum
• Best remedy for dissolving scars and adhesions.
• Helps soften hard keloids and hypertrophic scars.
• Gradual reduction in size over months.
• Used in post-surgical scars and fibrotic tissue.
• Helps prevent recurrence of keloids.
2. Silicea
• Chronic, hard, thickened scars.
• Slow healing wounds with pus formation.
• Useful for surgical and traumatic scars.
• Weak immunity, prone to infections.
• Cold sensitivity, worsens in damp weather.
3. Graphites
• Thickened, raised scars with burning pain.
• Oozing honey-like discharge from affected area.
• Useful for keloids with itching and dryness.
• Indicated in skin eruptions, eczema, and psoriasis.
4. Fluoricum Acidum
• Painful, irregular keloids with hard nodules.
• Burning sensation and itching.
• Better from cold applications.
• Indicated in scars from burns and ulcers.
• Useful for post-radiation fibrosis.
5. Calendula Officinalis
• Excellent wound healer, prevents excessive scar formation.
• Used in fresh wounds, burns, and surgical incisions.
• Helps in reducing inflammation and redness.
• Externally applied as Calendula ointment for healing.

Mnemonic for Homeopathic Treatment (T-S-G-F-C)

• T – Thiosinaminum (Scar dissolver).
• S – Silicea (Hard, chronic scars).
• G – Graphites (Thick scars, oozing).
• F – Fluoricum Acidum (Painful, burning keloids).
• C – Calendula (Wound healing, prevention).