General
Keloid scar
What is it?
A benign tumour like scar reaction that has extended beyond the boundaries of the original scar.
What is the cause?
- genetic (dark skinned people have a higher risk)
What are the symptoms?
- itchy painful scar
- enlarging lump
What are the treatment options?
- Step 1: silicone sheet therapy (at least 23 hrs a day for 6 months); and pressure eg compressive earrings
- Step 2: steroid injections
- Step 3: surgery
When should I see a Surgeon?
- when you are considering steroid injections or surgery
Lipoma
What is it?
A benign subcutaneous fat cell tumour.
What is the cause?
- idiopathic
- genetic
- some people experience numerous painful lipomas (Dercum’s disease).
What are the symptoms?
- mobile slowly enlarging subcutaneous lump
- most are painless
- can be painful
What are the treatment options?
- surgery
When should I see a Surgeon?
- when it concerns you enough to require surgery
- persistently painful rapidly growing and deeper subcutaneous lumps may be a sarcoma and need urgent surgical review
Scar revision
What is it?
Surgery to improve the contour, colour, or thickness of a scar. Scar revision may also be necessary when a contracted scar is causing a functional problem eg incomplete finger extension.
What is the cause?
- genetic
- some people have a tendency to form hypertrophic or keloid scars (see above). This often runs in the family. Dark skinned people have a higher risk.
- age
- younger skin often forms thicker and more reactive scars
- tension
- scars in areas of tension will more commonly produce widened and hypertrophic scars
- complication
- wounds that have become infected or have dehisced may form bad scars.
What are the treatment options?
- improve the colour
- red – laser
- hyperpigmented – laser
- improve the contour or width
- surgery
When should I see a Surgeon?
- when a scar has had 6-12 months to mature and you are unhappy with the outcome
Skin cyst
What is it?
A subcutaneous cyst that arises from epidermal cells trapped in deeper layers of the skin (epidermal inclusion cyst). Commonly known as a “sebaceous cyst”.
What is the cause?
- primary – related to a hair follicle
- secondary – skin cells can become trapped in deeper layers after trauma eg a laceration
What are the symptoms?
- enlarging subcutaneous lump
- discharges cheesy white keratin
- commonly becomes infected
What are the treatment options?
- surgery
- acute infection – abscess drainage
- chronic stable cyst – formal excision
When should I see a Surgeon?
- if it is acutely infected
- if it bothers you enough to warrant surgery