الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Keloid scars represent 10–15% of all wounds. They can appear anywhere on the body and can last for years after the initial injury. risk factors of keloid scars are usually patients younger than 30 years and have darker skin. Darkly pigmented skin is the primary risk factor for keloids, which has a 15–20-fold increased risk due to melanocyte-stimulating hormone anomalies. Black, Hispanic, and Asian persons are more likely to develop keloid scars than Caucasians. Keloid scars are usually associated with pain and pruritis and severe emotional distress.
Keloid scars have negative feedback on the mental health during the post-natal period and can contribute to negative body image, and symptoms of depression. Patients with keloid scars have been reported to be sad with their scar. Consequently, this can affect the communication skills, personal relationships and work of the patients and result in these patients being unsociable.
Based on the cellular mechanism of keloid formation, one of the first-line options to treat keloid scars is corticosteroid injection into the affected area. The steroids have both direct anti-inflammatory and vasoconstrictive effects. Administration of corticosteroids results in the whitening of keloid scars, suggesting a decrease of blood flow in the scar due to vasoconstriction.
There is also another treatment of keloid scar is surgical removal of the scar. However, since surgical removal of the keloid usually only provides temporary cosmetic relief and invariability followed by even more aggressive regrowth of scar tissue in 50–100% of cases, many clinicians perform surgical excision of the keloid scar followed by sub-dermal corticosteroid injections.