Hi Dr. Naderi,
I use to think that I had Keloid skin but after recently doing some research about it, I now believe that in fact it may be Hypertrophic scars. The first sign of this was when I had gotten my ears pierced at age 8, and actually, I wonder if I may possibly have both because my right earlobe is the only thing that got really big which brings about my first question, can you have both Hypertrophic scars and Keloids? I’ve had two C-Sections a Hysterectomy and abdominal surgery, all of which left a scar more like the discription of the Hypertrophic scars. Both my earlobes were affected but only the right one became really enlarged. Of course, the fact that it got infected also could of had something to do with it. What brought about all this researching after so many years is that I have been really thinking about getting my ears pierced again, which is actually something I have been wanting to do for years but clip ons had started getting better looking over the years so I put it off but now I’m just really tired of the clip on earrings because the selection still isn’t anything like the pierced earrings and I’m always loosing one of them. So recently I have been seriously considering it and that’s my second question, is it possible or is there a method that will allow my ears to be pierced without devoloping these scars again? I was told that the cause of the scars was metal contacting the raw skin, is that true? Any information would be helpful.
You can have hypertrophic scars as well as keloid scars. Hypertrophic scars are common on the body. On the face, I usually see them as a result of poor facelift incision closure when there is too much tension on the wound. While hypertrophic scars can be prevented to a large extent or minimized with good layered tension free incision closure, keloids are very tough to deal with.
Keloids are often seen in African American patients who have had their ears pierced. But keloids can occur anywhere on the body and they are due to excessive scar formation due to trauma and irritation. In grown hair or pimples can result in keloids for example. Its not rare to see keloids on one ear lobe but not the other! Other races can also get keloids.
The way to minimize keloids is to minimize trauma but by definition, piercing an earlobe causes trauma. You may not get another keloid but then again, you may and there is no way of guaranteeing you wont if you have had one in the past.
When the keloids are small, steroid injections may help. Usually though they have to be cut out and there serial steroid injections done for months and months to prevent recurrence.
I hope that makes sense.