Dr Darren I am desperate for any possible help right now.
I wrote to you after reading an article about Keloids as I have a problem with the itching and burning and the very sharp pains that I experience – you said in your article it can occur, but mine is severe and up to several times a day.
I had a Mastectomy (Left breast) but the surgeon reduced my right breast by removing the nipple and then sticking it back on after surgery. These scars have formed keloids on my breast and areola.
I have tried countless remedies and interventions and am fast losing hope – they seem to work for a day or two only. I consulted a Dermatologist who injected cortisone into the scars which flattened them for a bit – and the itching only stopped for a few days and then started again.
I am looking for advice as what to do next. Should I consider radiation or have it surgically removed? After the original mastectomy the scars under my breasts also made significant keloids and had to be surgically removed. It was a battle to convince the Medical Aid that it was not just cosmetic… I am at my wits end as the itching and burning sensation drives me to distraction! Please assist.

Thanks for your direct and honest account of your problem. Dealing with scar tissue is in itself is a great challenge as there are many variables at play that determine outcomes. Keloids can be debilitating as a complication of surgery – this occurs in people who have a tendency to produce excessive scar tissue formation during the healing process. Thick and even hard rubbery lesions can occur when too much scar tissue is produced. Inflammation and Fibrosis are the processes involved.
Like you correctly pointed out, in severe cases one could suffer from extreme pain as well as the discomfort due to itchiness. This itchiness is cause by the tightening hard scar tissue as well as the release of histamine in those areas. Skin irritation and burning can follow as products of inflammation are released at various sites.
The use of steroids has proved successful in many cases – the problem remains recurrence. Often the lesions are softened by natural oils like tissue oil and Vit E based products – Bio-oil is amongst the most popular. But the effect is often short lived and persistent dedication is required for success. Remember the location of the lesions and the specific weight or activity that the scar must carry also plays a role. Scar tissue is not as elastic and mobile as normal skin – the rigidity and tightness causes pain particularly with movement. When we consider the breast skin tissue, it is highly sensitive to touch and pressure. Your choice and comfort of underwear and its functionality versus being fashionable is often overlooked. Irritation and synthetic materials can add to the irritation. Poor ventilation and poorly fitted garments can aggravate the problem.

Having surgery to correct the complications of surgery is not always a great idea unless functional outcomes can be improved. In your case, I wish to point out that the use of silicone sheets have been used with variable results. Laser therapies have shown good results but long term effects need better research. Surgery is always an option but is never without risk. On a more conservative level – I recommend cold packs when it becomes unbearable and also trying antihistamine tablets (preferably non sedative) like Deselex, Telfast or Xyzal – for the suppression of histamine release locally. Topical antihistamine creams are also an option. Keep the skin well hydrated and always remember that the benefit should always outweigh the risks when considering any invasive procedures.

After reading an article about Keloids…
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