Before I start, I must apologise for my absence as of late. It has been quite a while since I last posted. Things have been very busy in the world of Kev. My job is keeping me exceptionally busy and I have been looking after Avril as she has been getting progressively worse as time has gone by. Unfortunately, I have not had the time nor motivation to blog. I endeavour to post on a more regular basis to make up for lost time!
In October last year, I wrote a fairly lengthy post about my skin condition (keloid scarring) and the journey that has led me to accepting my body for what it was. You can familiarise yourself with that post here. The post got a lot of attention along with positive feedback. It still gets daily hits so I thought I would pop on and give you an update as to how things have progressed since then. I know this is a divergence from the usual content posted on the blog but as myself and Avril always state, we are here to give people going through illness a voice and are not writing these posts to look for pity but purely to educate people. This post is to highlight such medical conditions that often remain hidden and to make people going through these conditions feel not so alone.
In December, I had an annual check-up with my Consultant Dermatologist. At this point, I had not received any form of treatment in 2016 and the scarring had gotten progressively worse. Unfortunately, I did not get to meet my Consultant at this appointment but instead met with a registrar who I had not met previously to review my extensive file. To save time reading this novella, I recounted all the treatment methods that I had undergone over the years (steroid injections, creams, silicon dressings, medication etc) in as brief an account as possible. The only option brought to the table was to undergo another six month course of (monthly) steroid injections aimed directly into each scar. As I have mentioned in my previous post, this is not a pleasant experience. It had not worked previously and is extremely painful to receive. My body tends to go into shock after each treatment with the immense pain lasting for hours. I tend to go to bed afterwards as it is the only way I can tolerate the pain until it subsides.
However, with my keloid scars growing progressively bigger in size and becoming increasingly tender and itchy, I decided to give the treatment another go. For the first three months and all previous treatments, the treatment nurses used a needle-less injection device called a Dermojet to administer the steroids. These devices use high pressure to drive the drug “painlessly” into the skin. I can categorically say that maybe it is a painless form of administration for normal healthy skin but when it is used to treat tender keloid scars it is extremely painful. All I can liken it to is getting punched exceptionally hard by a mini Mike Tyson. Another downfall of this treatment regime is that you are limited to receiving a maximum of ten “shots” per treatment. This, when you have a vast number of keloid scars means that you have to be very selective in which scars you choose to treat. In my case, the scars located on my chest are the ones that aggravate me the most so it made sense to focus on these. One of the particularly large scars on my chest was left untreated so it could act as a control for wants of a better word. This was undertaken as a means of being able to compare the actual treated scars to the original scars in order to see if the treatment was making any sort of difference.
Have I noticed any sort of improvement in the size/shape/sensitivity of them? Well for the first three months, no not really. The redness and the intense itchy feeling did subside briefly after each treatment but returned after a few days. The overall size and shape of the scars remained unaltered. The only scar that has remotely responded to treatment is the smallest scar located on my collar-bone. At the end of my third course of treatment, I had a discussion with the nurse and Consultant regarding the method of application. I was concerned about the use of the Dermojet and was wondering if it really was a superior treatment method to the standard needle. I personally felt that the Dermojet was not getting down deep enough into the skin to have any positive affects on the larger keloid scars. They did take my concerns into consideration and the decision was made to use a standard needle to administer the last three months of treatment. The only downside to this was that the nurses were not allowed administer the treatment as only a doctor can use the needle method. So for the final three months, the doctor injected the steroids directly into my scars using a needle. Whilst this method is uncomfortable it is by no means as painful as the dermojet. It causes very little bruising as opposed to the dermojet and my skin recovers at a much quicker rate.
Over the course of the three months, there was a slight improvement with regards the scars softening, however, there was no real reduction in their size. So where do I stand now? Well pretty much the same as I was a year ago to be perfectly honest. The doctors have exhausted pretty much every angle they can with regards “easy” treatment. I am not keen on going down the line of more serious treatments that have no guarantee of working. Long term steroid injections are not good for you and the doctors would mirror that opinion. Surgery to remove the scars will definitely not solve the issue as the method in which the skin heals is severely altered hence it could result in more prominent keloid formation. Which could in fact be worse that the initial scarring. The nature of this condition is that my skin just does not know when to stop the healing process and produces an excessive amount of collagen. This leads to a build up of scar tissue and hence the formation of a keloid scar. The other, more serious form of treatment involves the use of radiation therapy. This treatment however could lead to more serious skin conditions such as skin cancer and as a young man this is not a route I want to explore at this present moment in time. So what is my overall prognosis? Well realistically it is what it is. I have to pretty much just live with them. Unfortunately, there has been no recent developments with regards research into keloid scarring or methods to reduce the ever-present itch and discomfort. The little scars are tending to merge together to form larger scars and I can physically feel them grow. I am also experiencing some development of new small scars formation. I also have to be extremely cautious with sun exposure as I would have a higher chance of developing skin damage and skin cancer. I have a follow-up appointment in a years time at which point I will be brought into a clinic and my case discussed with a range of dermatologists. This is the protocol for unusual cases such as my own in order to try come up with some sort of new treatment plan. I underwent a similar meeting two years ago when they came up with these methods of treating me so fingers crossed something new can be brought to the table that might actually work for me. For now all I can do is grin and bear it.