Treatments
It must be noted that there is NO known cure for keloids that will totally cure the problem. There are a few companies that are working towards a more effective treatment, focusing on aspects such as Transforming Growth Factor inhibition.
Some of the treatment that are currently available are described below. These treatments have varying degrees of effectiveness. Usually, any inteference to a keloid can lead to it recurring and becoming bigger than it previously was.
* Surgery — Surgery requires great care during and after the operation. Keloids that return after being excised may be larger than the original. There is a 45% chance of recurrence after surgical removal. However, keloids are less likely to return if surgical removal is combined with other treatments. Surgical or laser excision may be followed by intralesional injections of a corticosteroid. Plastic closure of the skin including techniques such as v-plasty or w-plasty to reduce skin tension are known to reduce recurrence of keloids following excision.
* Dressings — Moistened wound coverings made of silicone gel (such as Dermatix) or silastic have been shown in studies to reduce keloid prominence over time. This treatment is safe and painless.
* Steroid injections — Steroid injections are best used as the scar begins to thicken or if the person is a known keloid former. A series of injections with triamcinolone acetonide or another corticosteroid may reduce keloid size and irritation. However injections are often uncomfortable and in large and/or hard scars can be difficult to inject requiring local anesthetic for people over 16, and full anesthetic for people under. The treatment area can become very painful as the anesthetic wears off.
* Compression — Compression bandages applied to the site over several months, sometimes for as long as six to twelve months, may lead to a reduction in the size of the keloid. This is the best treatment at preventing new scars.
* Cryosurgery — Cryosurgery is an excellent treatment for keloids which are small and occur on lightly pigmented skin. It is often combined with monthly cortisone injections. The use of cryotherapy is limited since it causes skin blanching. It freezes the skin and causes sludging of the circulation beneath, effectively creating an area of localized frostbite. There is a slough of skin and keloid with re-epithelization .
* Radiation therapy — Electron beam radiation can be used at levels which do not penetrate the body deeply enough to affect internal organs. Orthovoltage radiation is more penetrating and slightly more effective. Radiation treatments may reduce scar formation if they are used soon after a surgery while the surgical wound is healing. This is one of the more costly procedures.
* Laser therapy — This is an alternative to conventional surgery for keloid removal. Lasers produce a superficial peel but often do not reduce the bulk of the keloid. The use of dye-tuned lasers has not shown better results than cold lasers.
* Newer treatments — Drugs which are used to treat autoimmune diseases or cancer have shown promise. These include alpha-interferon, 5-fluorouracil and bleomycin. However, there is a need for further study and evaluation of this treatment technique.
* Natural treatments (in case of piercings)- Take a warm rag and hold it up against the keloid for about 5 minutes. This can also be done with a warm tea bag. Tea tree oil is also effective but is not recommended because it is an oil and oil can allow bacteria to stick to it.
[edit] Case presentation
What is best treatment available for keloids?
ask your dr to inject you with kenolog-10, this is the best way to treat it
Reply:Keloids are an overgrowth of scar tissue at the site of a healed skin injury. Keloids often require no treatment. Keloids may be reduced in size by freezing (cryotherapy), external pressure, corticosteroid injections, laser treatments, radiation, or surgical removal. It is not unusual for keloids to reappear (sometimes larger than before) after they have been removed.
Discoloration from sun exposure can be prevented by covering the forming keloid with a patch or Band-Aid, and by using sunblockers when spending time in the sun. These extras protection measures should be continued for at least 6 months after injury or surgery for an adult, up to 18 months for a child.
Please see the web pages for more details on Keloids.
