Do any factors predispose to hypertrophic scars and keloids? Many factors can predispose individuals to develop hypertrophic scars and keloids: - Certain drugs (e.g., isotretinoin) predispose to hypertrophic scarring, and most dermatologic surgeons defer any elective surgery for at least 1 year following discontinuation of isotretinoin.
- The type of injury and degree of tissue injury also play a role. Thermal burns, with their associated severe tissue damage, commonly produce hypertrophic scars or keloids.
- Regional variations exist. Skin that is continuously under tension or tightly stretched over bony protuberances and other anatomic peculiarities predispose to the development of hypertrophic scarring and keloids.
- Dark-skinned races are more prone to both hypertrophic scarring and keloid formation. Blacks are 2 to 19 times and Asians 3 to 5 times more likely than Caucasians to develop keloids. The tendency for multiple keloids to occur in families also suggests a genetic predisposition.
- Certain genodermatoses such as Ehlers-Danlos syndrome, Rubinstein- Taybi syndrome, osteogenesis imperfecta, and progeria have all been reported to have increased risk for the development of keloids.
Bayat A, Arscott G, Ollier WE, et al: Keloid disease: clinical relevance of single versus multiple site scars, Br J Plast Surg 58:28–37, 2005. |
