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Keloid Flattening and Softening Treatment 

Questions and Answers

1. My skin itches when I applied the ointments. Why?
2. Can I use the Hei Ba Gao for hypertropic scars?
3. How long will it take before I see effect?
4. Why use a combination of treatments?
5. Why does it take so long to see my keloid flatten?
6. What signs do I look for to see if it is working?
7. What would be your advice for the best treatment ?
8. Why do I feel some pain after resuming treatment with the Hei Ba Gao?
9. What factors affect the success of the treatment?

1. My skin tingles when I apply the Hei Ba Gao. Why?

The user will initially feel a light biting sensations as the skin gets accustomed to the Hei Ba Gao and/or Ba Hen Ling. Alternatively, if the user does not experience any biting sensation, it does not meant that the Gao is not working. If the skin is more sensitive, these sensations can be more pronounced, especially if the skin is dry.  An active keloid responds to treatment by producing collagen fibers just as quickly as they are broken down and this is reflected in the rosy appearance of the keloid during treatment. The Hei Ba Gao is drying in nature and can cause drying of the skin during treatment where the skin becomes red and there is some superficial peeling. In this case, use the Hei Ba Gao over longer intervals, eg. one application every 2 days. The use of moisturisers can help to soothe the dry skin.

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2. Can I use the Hei Ba Gao for hypertropic scars?

Yes, if you are initially unsure if the hypertropic scar will develop into a keloid. But after 9 months and the scar does not seem to grow larger and thicker, it is unlikely a keloid. The Mili Chu Ba Gao is more suitable for hypertropic scars.

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3. How long will it take before I see effect?

Result can be seen in days (for keloids not treated by invasive methods prior). We must remember that the objectives of the treatments are to: 1) ensure that collagen formation and production is reduced, 2) the symptoms of pain and itch is eliminated and 3) the keloid mass gradually thins. Please note that to make the keloid disappear as if it is never there is not possible. As a keloid flattens over time, there will still be light pigmentations over the location of the keloid. Throughout the process of flattening, the appearance of the keloid will not be uniform. Some parts of the keloid are flatter than other parts. However, its appearance will improve over time. The thinning sequence of the keloid goes through the process of 1) breaking down the collagen mass, 2) the counter-response of the collagen production and 3) the breaking down the collagen matrix again. This sequence ensures that the keloid formation process does not spread beyond the size when the treatment is applied. Over sustained use, the user will see a gradual thinning of the keloid as well as an improvement of the skin color. The user must ascertain the type of scars he/she has. If it is a hypertropic scar, the Ba Hen Ling snake fats cream is recommended.

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4. Why use a combination of treatments?

In Traditional Chinese Homeopathy, we look at the entire process of a problem so as to eradicate the root cause. This ensures that we treat not only the symptoms that so inconvenience the person by also to eliminate any recurrence. Alternating between treatments also ensures that we do not provide a fixed pattern of intervention for the skin to adapt to. It is important that whatever formulas are dispensed are modified to fit the individual needs of specific patients.

The keloid continually form the scar tissues which makes it bigger and harder. Steroid injections suppresses the symptoms but the side effect is great. The Hei Ba Gao dissolves these tissues and discourages growth but it cannot stop the scar tissues from forming completely. It can only stop the scar tissues from forming completely when the keloid matures. That is when the result is permanent. The Hei Ba Gao accelerates the maturity of the keloid. There is no side effects of more keloids forming or the keloid being more aggressive when the Hei Ba Gao is used. However, if the keloids have been injected with steroids prior to using the Hei Ba Gao, the keloid may be fluctuate in size and redness in greater intensity. Steroids remain in the skin for years and as its effects wear off and the skin begins to register the trauma from the injections, the keloid matrix will begin a process of more aggressive growth.

5. Why does it take so long for me to see my keloid flatten?

The keloid is part of the skin. The skin is an organ and the keloids are the tumours of this organ. It is grown in the skin and is formed as a process of cellular activity. It is the result of a skin disorder, not caused by external agents like virus or bacteria. Unlike such diseases caused by external agent, the body can help the medication process to expel the external agents and restore the normal function of the body. Time is therefore needed to establish a pattern of cellular activity where a keloid is gradually matured, allowing the treatment to increase its effect. Significant results see in users range form weeks to months and some a year or more. factors to consider include: 1. age of the keloid, 2. its location, 3. the diet of the user (in tandem with his allergy status). 4. the thickness of the keloid, the area spread of the keloid. 

The clinical experience with thousands of users shows that a certain affect occurs after applying the medicine for just 1-4 days, while the total duration of treatment is often just 3-9 months for untreated and new keloids. More advanced cases with larger keloid densities may take 18 months or more. The rate of effective treatment is over 98% and the rate of cure is over 84%. The keloid does not recur if the general guidelines of diet and wound care are observed during treatment. The earlier a scar is treated, the earlier will a user see positive result. The reason is that the keloid hardens over time as fibrous scar tissues build around each other, creating layers upon layers of dense scar fibres.

6. What signs do I look for to see if it is working? 

Over the course of treatment, you will see signs that that shows a gradual normalization of the skin: 1. softening of the keloid, allowing greater freedom of movement, 2. itch and pain has subsided, 3. wrinkling of the keloid, as the inner mass gets smaller, the outer skin wrinkles, 4. the breaking up of a large keloid into smaller ones and lightening of the keloid's redness, 5. growth and spread stops,  6. thinning of the keloid mass and 7. growth of hairs on a flattening keloid. Repair often takes a few phases, beginning with the caving in of the center of the keloid, at the same time, swelling of the two ends. The flattening at the center of the keloid is an indication of the gradual resolution of the scar tissues by the skin. In the final phase, the swelling of the two ends subside and the entire keloid becomes flat. But there will still be a scar of shiny and wrinkled skin. The difference is that it is quite flat, less red and does not grow nor itches. A normal scar is different from a keloid in that a keloid is a growing, living vegetation of tissues.

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7. What would be your advice for the best treatment?

From numerous feedback and clinical trials, the Hei Ba Gao is the most optimistic treatment. The Hei Ba Gao can be used concurrently with the Ba Hen Ling as well as the Ba Hen Ling with snake oil. We advocate a no needle, no steroid approach.

Every injection wound has the potential to form into a new keloids, which is why you may see the formation of multiple keloids for no apparent reason.
Once the steroid wears off, you may see some aggression of the keloid, meaning it gets larger and harder. Do note that it is not the result of the Hei Ba Gao. The trauma sustained by the skin from the multiple deep tissue injections had done some damage and we need to allow some time for the skin to recover and to heal from the trauma. If your keloid has been treated with steroids, the Hei Ba Gao should be used for a much longer period of time. Once you discontinue the treatment, the result will be short lived. Many customers expect sustained result from 1-2 bottles but it is really not realistic. Even for steroid injections, treatment must be sustained every 2-3 months indefinitely.

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8. Why do I feel some occasional pain when I resume treatment?

The Hei Ba Gao softens the collagen fibres to prepare it for flattening. When treatment is discontinued, the fibers become robust and hard again. Thus, when treatment is resumed, the fibers are again softened, causing some discomfort. 

The Hei Ba Gao works like a mask and may dry the skin if the paste is constantly applied onto the surrounding skin. The surrounding skin is more delicate and can become brittle if the paste is always applied on it. Hence, do try to avoid the surrounding skin when applying the paste. Occasional over-flow of the paste onto the surrounding skin is fine.

The climate can also affect this feeling of dryness. Colder weather tends to make the skin dry and the paste should be used at longer intervals instead of daily.

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9. What factors affect the outcome of the treatment?

Numerous factors affect the result of the tretment. These include:

A. Family history
B. Predisposing and causative factors
C. Age of scar
D. Type of scar
E. Anatomic location of scar
F. Prior treatments

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