Treatment of Back Keloids in Los Angeles
The back and shoulders are a common area for expression of keloid scars. Clinically, back and shoulder keloids occur as isolated lesions or in clusters. Keloid clusters are particularly difficult to treat as they often form contiguous masses with myofibroblast induced contraction of scars.
Some keloid clusters are due to a history of acne vulgaris, while others may be due to multiple iatrogenic scars from overaggressive mole removal. Acne can cause back and shoulder keloids to form as the inflammatory or infectious component of the acne pustule subsides. A rim of hyperpigmentation usually progresses and the central core becomes thickened, first as small dermal nodule, then as a dense nodular lesion that progresses beyond the plane of the skin.
Some clinicians believe that acne-induced keloids on the back, shoulder, or chest are due to an immune reaction mounted by the body against the sebum contained in an acne pustule. In other words, the body does not recognize the sebum as coming from the body, but rather as a foreign body. This is very similar to a splinter or foreign body in the skin. The body begins to mount an immune response to wall off the foreign body. In keloid scars, this mechanism may account for the association of acne and keloid scars formation.
The initial treatment plan for acne keloids on the back and shoulders is to minimize the amount of oiliness on these areas.
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