Keloids - Trying To Understand Its Nature

yerrag

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I have plenty of keloid scars. I've given up long ago trying to get rid of them. But they still pique my curiosity.

Keloids are scars that do not heal normally. They end up as a lump over the site of the wound, as a piece of hard flesh that sometimes irritates. They do not flatten but even grow. The wound may be externally caused, with punctures and lacerations. Areas where the skin is thick are more vulnerable to it, such as the chest and shoulders, and some parts of the face lining the jaw. The wound can also come from boils, which is internally generated. Keloids are rather selective, and there's no telling when or where they would grow.

I've one grow from my left earlobe, and it stuck out like a sore thumb, like a piece of grape. Luckily, I was able to go Boston, to the Lahey Clinic, to have it cut out, and in order to arrest the keloid from returning, it was subjected to radiation. It only had to be done once, and I was told not to go back if the keloid resurfaced. And luckily, I didn't have to.

I have other keloids on my left shoulder, and on my chest and torso, where most of the keloids are. I've been through a series of injections of hydrocortisone to remove them. But it's been a hit or miss approach. Some have subsided yet are visible as hypertrophic scars. But many remained entrenched. There were even keloids that were close enough that decided they needed to be together, and so they got together and fused to form a few superkeloids.

But it is through my ordeal with keloids that I had to go outside conventional medical channels. I ended up fixing other issues I had, even though blasting away the keloid to kingdom come was my goal. So, there is a little to be thankful for in having these keloids. It is cosmetic only, and where once I would be conscious about them, nowadays it is to me just a 3d tattoo by an unskilled artist.

Reading through Peat's articles, I've come to understand keloids with these ideas:

- that it is a form of cancer, but benign, where the skin has lost its ability to differentiate when it regenerates, for one reason or another. The skin does not know to stop dividing and growing. It would stop eventually, but it would leave a mass of tissue that is hard, but this tissue is not what a normal regenerative healing of skin would produce.

- the incidence of keloid is more common the darker the color of skin. This is what I've been told by doctors. If skin color is a key differentiator, I think that this would have to do with melanin. And that perhaps it would also be affected by the level of exposure to sunlight, and vitamin D, and the parathyroid hormone. Would low levels of exposure to sunlight cause more keloids to form? My own experience would push me towards this conclusion. I didn't have any keloid on my chest when I went to the US, but the keloids appeared when I was studying in Rochester, NY, which is up north and receiving less direct sunlight.

-the keloids are very tough, and Ray mentions that as people age, the tissues become tougher as the skin becomes tougher, and this had to do with more collagen being used on the matrix that forms the skin and tissues. It makes me think that the keloid could simply be an expression of an unhealthy environment in the body. What makes this environment unhealthy?

Questions:

1. I had mercury toxicity then. Mercury binds to to the oxygen receptors in the hemoglobin of blood. The higher the toxicity, the less oxygen blood would carry. It could be that with the lack of oxygenation of my cells. Would this condition affect the way my skin heals?

2. I would sweat a lot then. This sweat would make my skin form a rash, or a boil, and this would be a site for keloid formation. I wonder also if my keloid is formed from the skin reacting in an autoimmune way to a foreign substance, such as mercury, which would perhaps find its way into my skin pores and cause a boil to form, with the skin being an organ of elimination. Is this a possibility?

3. Now that I have removed the mercury toxicity, I have regained the normal level of oxygenation and it is seen in my endurance levels when I run (although I've stopped running). I am less prone to forming keloids now, but the ones that are already there remain with no sign of them going away. Is there anything I could try to remove these keloids? A gentle approach? If it is a cancer, how do I get the body to dissolve it away on its own the away the body eats a cancer by phagocytic action? Do phagocytes work on the skin-surface level? I know I said I'm not interested in finding a cure, but hey, I'm also curious from the standpoint of it being a cancer, however benign it really is.

4. Given that keloid affect darker-skinned people more, is there any mechanism involving the lack of sunlight that would have a bearing on mediating a keloid? A lack of calcium? A lack of vitamin D? Or an excess of PTH?

Thanks.
 

raypeatclips

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4. Given that keloid affect darker-skinned people more, is there any mechanism involving the lack of sunlight that would have a bearing on mediating a keloid? A lack of calcium? A lack of vitamin D? Or an excess of PTH?

Have you ever had any of those levels tested in yourself? It would be interesting to test those levels and test the levels of other people with the condition to see if you're onto something.
 

achillea

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Bee venom injections where the needle is put in one end of the keloid and worked to the other end then as it is pulled out the venom is injected. Or you can put hyaluronic acid on it during the repair or later after it is formed.. Apply liberally and it takes a long time. Even injecting the hyaluronic acid itself would work fine. sometimes it is very hard to get a needle in the tissue as it is so hard and old, so soften it a few days with the hyaluronic acid.
 

lvysaur

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the incidence of keloid is more common the darker the color of skin. This is what I've been told by doctors. If skin color is a key differentiator, I think that this would have to do with melanin.

This is an oversimplification, it probably has very little if anything to do with skin tone. I'm very dark, and I've never had a keloid, nor have I ever seen any on people from my family or ancestral group. I've seen tons on African-Americans, though.

Keloids: Definition and Historical Background, Epidemiology, Race

Unfortunately can't find the full text, but supposedly Chinese people get more keloids than Indians/Malaysians. That wouldn't make sense either if it was color-based.
 
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yerrag

yerrag

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Have you ever had any of those levels tested in yourself? It would be interesting to test those levels and test the levels of other people with the condition to see if you're onto something.

Unfortunately, not at the time when my keloids were actively forming. I would say though that my eating habits then were not of consciously taking enough calcium, therefore my calcium levels would have been low. Couple that with being in an area close to the Canadian border (Rochester, NY), and not actively getting sunlight, I would likely be vitamin D deficient at that time.

Adding confirmation to my low calcium levels would be the state of my teeth. I had about 11 mercury fillings to patch many cavities. Ray had mentioned that low calcium levels also lead to more cavities in the teeth, as the condition causes calcium to be leached out from our bones, and that includes our teeth. I remember brushing my teeth religiously, but was just frustrated that I would get cavities so easily. These days, having increased calcium intake, I no longer have issues with teeth cavity, although I now also do oil pulling and for some reason, do not have plaque forming around my teeth as much as before.

I don't know though why, though, that the lack of calcium and Vitamin D would find expression in the formation of keloids, if this is indeed the case. The lack of calcium could easily lead to calcification of tissues and organs, and stones, but these situations weren't expressed. Perhaps the body prefers to express pathologies on the surface level first, because it is less harmful. A cosmetic expression also alerts the bearer to the existence of a crisis building up?

Bee venom injections where the needle is put in one end of the keloid and worked to the other end then as it is pulled out the venom is injected. Or you can put hyaluronic acid on it during the repair or later after it is formed.. Apply liberally and it takes a long time. Even injecting the hyaluronic acid itself would work fine. sometimes it is very hard to get a needle in the tissue as it is so hard and old, so soften it a few days with the hyaluronic acid.

Interesting. I have to look into this further. So what you're saying is the hyaluronic acid would soften the keloid, and yes, the keloid is very hard. And this would would help with the bee venom injection. Do you have any links? This is a novel approach and I've not heard of this, although I know that bee stings are used to treat people. But a bee venom injection seems to be different from a bee sting.


This is an oversimplification, it probably has very little if anything to do with skin tone. I'm very dark, and I've never had a keloid, nor have I ever seen any on people from my family or ancestral group. I've seen tons on African-Americans, though.

Keloids: Definition and Historical Background, Epidemiology, Race

Unfortunately can't find the full text, but supposedly Chinese people get more keloids than Indians/Malaysians. That wouldn't make sense either if it was color-based.

I don't get your point. Please explain what you mean. Your linked page says this;

Studies have consistently demonstrated that persons of certain races are more susceptible to keloid scar formation. Individuals with darker pigmentation, black persons, and Asian persons are more likely to develop keloids. [5] In a random sampling of black individuals, as many as 16% have reported developing keloid scars, with an incidence rate of 4.5-16% in the black and Hispanic populations. White persons and albinos are least affected. Alhady's 1969 study found that Chinese individuals were more likely to develop keloids than Indian or Malaysian individuals.
 

lvysaur

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I don't get your point. Please explain what you mean. Your linked page says this;

I'm saying that if you grouped humanity by skin color, you wouldn't see more keloids in darker people as a rule.

"Chinese individuals were more likely to develop keloids than Indian or Malaysian individuals. " The former are obviously much lighter than the latter two. So the primary correlation factor isn't skin color, but ancestry.

Thus, the interplay of vitamin D is probably not a major factor.
 
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Ray Peat says keratinization is a reaction of the cell when it is unable to differentiate. I imagine scarification is a step before that.
 
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yerrag

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I'm saying that if you grouped humanity by skin color, you wouldn't see more keloids in darker people as a rule.

"Chinese individuals were more likely to develop keloids than Indian or Malaysian individuals. " The former are obviously much lighter than the latter two. So the primary correlation factor isn't skin color, but ancestry.

Thus, the interplay of vitamin D is probably not a major factor.
I would have to disagree with you. You failed to explain the statement, which I had boldfaced "ndividuals with darker pigmentation, black persons, and Asian persons are more likely to develop keloids." But you just went ahead and used the statement "Chinese individuals were more likely to develop keloids than Indian or Malaysian individuals. " to favor your the narrative that clears darker-skinned people of the tendency to have keloids.

From the same article you linked to : "In a random sampling of black individuals, as many as 16% have reported developing keloid scars, with an incidence rate of 4.5-16% in the black and Hispanic populations. White persons and albinos are least affected."

Are you disagreeing with me more out of your own personal observation that your family and relatives don't have keloids, even with dark skin, and using that as basis? Do you think you have enough sample size to make that conclusion?

Why don't you ask why light-skinned people are not as likely to develop keloids? Do light-skinned people share one ancestry?

That you and your family don't have keloids is no basis to state that dark-skinned people are not more prone to keloids to lighter-skinned people. If the lighter-skinned Chinese have more keloids than the darker-skinned Malaysians and Indians, it does not negate the fact that the Chinese in Malaysia still have darker and more pigmented skin than Caucasians.

It is still possible to group dark and brown and yellow-skinned people together, and say this group of people are more likely to develop keloid than lighter-skinned people.

Who is likely to have skin cancer such as melanoma? It's the lighter-skinned people. Do dark, brown, and yellow-skinned people get higher incidences of melanoma? No. Would yellow-skinned people get higher incidences of melanoma than brown-skinned people. Not that I know of. I've never heard of melanoma in people that are not white.
 
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yerrag

yerrag

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Ray Peat says keratinization is a reaction of the cell when it is unable to differentiate. I imagine scarification is a step before that.
Are cells that lose the ability to differentiate necessarily cancer cells? That is my impression.
 

lvysaur

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You failed to explain the statement, which I had boldfaced "ndividuals with darker pigmentation, black persons, and Asian persons are more likely to develop keloids."

That's easy. America basically has four racial groups: black, white, Hispanic, and Asian (east).

I'm disagreeing with you based on personal observations and evidence/lack thereof. The albino thing is based on a lack of evidence, rather than evidence of absence. I have seen keloids, almost solely on black and Hispanic people.

There's no narrative here. Is it based on skin color, or is it based on ancestry? It seems to be primarily based on ancestry. So the vitamin D thing is likely unimportant in the scheme of things.

Keloid incidence in Asian people and its comorbidity with other fibrosis-related diseases: a nationwide population-based study. - PubMed - NCBI
 
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Are cells that lose the ability to differentiate necessarily cancer cells? That is my impression.
No, skin cells do this all the time without consequence.

vitamin A is necessary for the proper differentiation of cells in skin and other membranes. A deficiency tends to cause an increased rate of cell division, with the production of abnormal cells, and a substitution of keratinized cells for other types. Estrogen also promotes keratinization and speeds cell division. A deficiency of vitamin A can cause leukoplakia in the mouth and on the cervix of the uterus; although this is considered "pre-cancerous," I have found it to be very easily reversible, as I have discussed elsewhere.6 I suspect that the intracellular fiber, keratin, is produced when a cell can't afford to do anything more complex. Adequate vitamin A speeds protein synthesis, and allows it to be used more efficiently.
 
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yerrag

yerrag

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That's easy. America basically has four racial groups: black, white, Hispanic, and Asian (east).

I'm disagreeing with you based on personal observations and evidence/lack thereof. The albino thing is based on a lack of evidence, rather than evidence of absence. I have seen keloids, almost solely on black and Hispanic people.

There's no narrative here. Is it based on skin color, or is it based on ancestry? It seems to be primarily based on ancestry. So the vitamin D thing is likely unimportant in the scheme of things.
Okay, no narrative. If you want to be more specific, it is based on ancestry. If you want to be more general, it is based on skin color. And if you want to be precise, it is based on the type of skin that possesses enough pigmentation that is enough to keep them protected from the sun. That type of skin is darker than normally you would find with Caucasian skin.
 
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yerrag

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lvysaur

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And if you want to be precise, it is based on the type of skin that possesses enough pigmentation that is enough to keep them protected from the sun.

Except that it's not, and that qualification you made is exactly equivalent to "skin color". You're basing some of your questions and reasoning on a false premise (keloids happen on the darker), when the premise is really something more like "keloids happen on the more African".

Keloid and Risk From Head and Neck Surgery
 
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Ray has written about this.

Cells with low glucose and hypoxia end up in disorganized matrices of collagen. The collagen is a protective mechanism to keep these cells from becoming cancerous and spreading around the organism, is my impression

The steps are inflammation --> fibrosis --> calcification, the last step where cells take up calcium in their death throes.

That's my simplified version because I am a simple person

Keloids can prevented by good energetics. Raising CO2 levels, going to altitude and living there for awhile, getting plenty of sugar and good nutrition, lowering endotoxin loads, red light, OJ, aspirin, etc.

They may be reversible with proteolytic enzymes.
 
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yerrag

yerrag

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Except that it's not, and that qualification you made is exactly equivalent to "skin color". You're basing some of your questions and reasoning on a false premise (keloids happen on the darker), when the premise is really something more like "keloids happen on the more African".

Keloid and Risk From Head and Neck Surgery
And then I need to be redefined.
 
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Cells with low glucose and hypoxia end up in disorganized matrices of collagen. The collagen is a protective mechanism to keep these cells from becoming cancerous and spreading around the organism, is my impression

That seems likely. Where did Ray Peat write this?
 
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