Surgery patients can now discover if they are at risk for severe scarring after surgery – thanks to a simple DNA test with the mouth.
The first screening of its kind takes less than a minute and is completely risk-free.
After a week the results are ready and they can indicate whether there is a low or high chance of developing an abnormal scar.
Scars are a natural sign of skin repair. While a wound heals, chemicals are released that cause the formation of new blood vessels and skin cells, thereby closing the wound and preventing infections.
Although they may be red and raised in the beginning, they usually turn pale, flat and almost invisible over time. This process can take up to two years.
The first screening of its kind takes less than a minute and is completely risk-free (stock image)
Some scars remain lifted and may widen – known as a hypertrophic scar – usually due to stress or damage to the skin during the healing process.
In a minority of patients, however, the healing process takes place in an abnormal way and there is an overproduction of the skin protein collagen, resulting in a so-called keloid scar.
These scars are red, thick and raised and can be much larger than the original wound.
They can also be itchy, soft and even painful – although the biggest concern for most patients is that they can be malforming.
Even small wounds can trigger the process that occurs a few years after the first trauma.
Certain ethnic groups – particularly of Irish, African and Caribbean descent – are much more likely to suffer, and although keloid scars sometimes occur in families, they can often happen spontaneously.
Now the French medical company BILHI Genetics is the first to develop a test that, he says, can identify genes associated with a risk of keloid scars.
The Bilhi Skin Keloid test is performed by a doctor and includes the use of a simple mouth-iron kit. A small plastic rod, with a cotton pad at the end, is rubbed along the inside of the cheek. This is then sealed in a package and sent by post to the BILHI laboratory for analysis. The results are returned to the doctor within seven to ten days.
Patients are told whether they have a low risk (twice as likely as the general population) or a high risk (eight times as likely) to develop a keloid.
After a week the results are ready and they can indicate whether there is a low or high chance that an abnormal scar will develop (stock image)
"The idea is to offer this to patients before they choose to undergo surgery," said London-based plastic surgeon Olivier Amar, the first to offer the test in the UK.
"This way we can follow the wound while it heals.
"If it looks like a raised keloid scar is developing, there are steps we can take to minimize the problem.
"Trying to treat a keloid scar after it has been developed is very difficult and can involve further surgery."
Currently, patients with elevated keloid scars are offered different treatments.
Freezing of early keloid scars with liquid nitrogen can stop them from growing, and laser treatment can reduce redness – although this will not make the scar smaller.
For more severe keloids, surgery involving the removal of abnormal tissue, sometimes followed by radiotherapy, may be an option. However, this can lead to worse scars than before.
Patients may even be offered chemotherapy drugs that stop the growth of rapidly dividing cells, along with steroids.
However, it is much better to try to prevent the keloid from developing in the first place, Mr Amar said.
"If we suspect a keloid scar is developing, we can give Botox injections or anti-inflammatory drugs that help minimize tissue redness and overgrowth," he explained. "Covering the healing scar with a self-adhesive silicone film or silicone gel is also useful and can help keep the skin flat.
"It is important for people to know that preventive measures can be taken because these scars can really affect self-confidence."
The company hopes that the test, which costs around £ 350 to perform privately, will one day be offered to selected patients on the NHS.
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