Keloids are commonly mis-understood even by doctors. Not much is known about why they occur and why in some individuals. But they sure pack a punch when it comes to giving pain and sufferring to those undortunate victims. Here are two stories that go to show that these nasties are not merely of cosmetic concern but can lead to a lot of sufferring.
In constant pain
An african gentleman came to see me a few years ago, he was a bit stooped and seemed to hold his arms very still and stiff. He was brought in by his daughter. She said he was in constant pain in his chest area and had reached his wit’s end trying to find treatment. On exposure, i could see that his chest was totally branded with many transverse ridges – all of these were keloids, there were about two dozen bands!
His story was that they started as small bumps on his chest, which soon joined up into bands. He went to a doctor in his country who removed them and stitched up the skin. He now had even bigger scars. Just as he was recovering from this, soon in 2 months these scars started growing rapidly. It was almost as if they had a mind of their own. They constricted his chest in a vice grip, making every breath painful. He was given local injections by another doctor but these were too painful to endure. He was desperate for any help.
When i mentioned that he needs steroid injections into the keloids, he broke down crying; it was strange to see a grown man reduced to tears. I could see that pain had wrecked him and had taken away all his fortitude. We then decided to do the injections under general anesthesia. This decision was also taken due to the sheer numbers of the keloids he had on his chest as well as limbs.
After just two such sessions we saw a remarkable improvement in his situation. Subsequent injecitons were administered under local anesthetic. He got a long lasting improvement. I kept seeing him for 4 years, there was no relapse.
These are keloids. They affect people of Arfican descent more but can be found in all parts of the world. Many of my patients have developed it on the scars of their heart by-pass operations. Although many have been treatment failures, i have noted that with dedicatied and correct care almost all of them can be improved. This is an orphan condition that causes a lot of sufferring but which most insurance companies do not want to cover. Hoping that the situation changes soon…