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By Anke van Eekelen

Not all healing processes have happy endings.

Some wounds develop keloid scarring during healing, leaving the patient with a disfiguring growth.

The phenomenon affects more people with higher levels of pigmentation in their skin. While Caucasian people are not as susceptible, Australia’s multicultural mix means that up to 20 per cent of the population is at risk of developing the ugly scars.

They are the result of an uncontrollable and aberrant wound healing process. Most often seen on the upper body and neck and face areas, they present as scar tissue having overgrown a wound site. Besides being painful and functionally impairing, keloid scars can also affect mental health and quality of life.

Injuries, as small as needle injection sites, insect bites or ear piercing can trigger keloid scarring in those at risk. The only treatment is surgical removal.

At Royal Perth Hospital, a new study will test a novel type of wound treatment after surgical removal of keloid scars to avoid the reoccurrence of a new one at the same site.

This research trial was initiated by Dr Patricia Danielsen, a Danish dermatologist in training from Copenhagen University and current visiting research fellow at Winthrop Professor Fiona Wood 's Burn Injury Research Unit at UWA.

With the help of volunteer patients, her study aims to test the beneficial effects of a drug called Verapamil on wound healing in people with keloid scars. The drug is better known as anti-hypertension medication, widely prescribed to people with cardiovascular disease.

Fibroblast cells in keloid scars do not respect the boundaries between the injury site and the surrounding healthy skin. In closing the wound, they don’t stop growing and produce too much collagen.

Verapamil will be used to relax these wound-healing cells. The drug is known to reduce tension between blood vessel cells to fight hypertension and in the keloid treatment study, Dr Danielsen anticipates that a similar effect will reduce the unstoppable growth of scar tissue cells and the amount of collagen they produce.

Normally, removal of a keloid is followed by local corticosteroid injections in the wound. Surgery alone to remove the bulk of the outgrowth is never enough and further treatment is needed to prevent a keloid from growing back, often even bigger than before.

But corticosteroid injections come with the risk of significant, more systemic side effects throughout the body.

In the new randomised trial, the effect of very low doses of Verapamil will be compared to regular corticosteroid injections in each study participant. Different injections on opposite sides of the new wound after keloid scar removal will allow volunteers with different skin types to take part. They will be their own control.

Professor Wood will operate on all eligible participants of the trial. Dr Danielsen needs volunteers with keloid scars to participate in this study, which is supported by the Fiona Wood Foundation.

For more information, please call 6488 8133 or visit Fiona Wood Foundation .

(Dr Anke van Eekelen is a neuroscientist and honorary research fellow at the Telethon Institute for Child Health Research, with a postgraduate diploma in Science Communication.)

Published in UWA News , 26 November 2012