Keloid Scars

Keloids are a type of raised scar. They occur where the skin has healed after an injury. They can grow much larger than the original injury that caused the scar. They can cause pain, itching and irritation. Anything that can cause a scar can cause a keloid.

There are several treatment options available for keloid scars:

Corticosteroid Injections

These injections are the preferred treatment option for most keloids. When injected into the keloid, these medicines help to shrink the scar both in height and width.

Patients usually receive a series of injections once every three to four weeks. Most patients return about four times for these injections. The first injections tend to relieve symptoms and make the keloid feel softer. Between 50% and 80% of keloids shrink after being injected.

Surgical Removal

This treatment involves surgically cutting out the keloid. While this may seem like a permanent solution, it’s important to know that nearly 100% of keloids return after this treatment. To reduce the risk of a keloid returning after surgical removal, dermatologists often treat patients with another treatment after the surgery. Injections of corticosteroids or cryotherapy may help reduce the risk. If the keloid is on an earlobe, wearing a special earring that puts pressure on the earlobe can prevent the keloid from returning. Receiving radiation treatments after surgical removal may also prevent a keloid from returning.

Pressure Earring, Dressing, or Garment

Putting pressure on the keloid reduces blood flow, stopping it from returning after treatment and can soften and reduce the height of existing keloids. Between 90% and 100% of patients who use this treatment as directed after keloid surgery can prevent another keloid.

Using this as directed, however, can be difficult. These devices tend to be uncomfortable. A patient must wear it for up to 16 hours a day for 6 to 12 months to get results. The pressure earring tends to be the easiest to wear. It is often recommended after a dermatologist removes a keloid from an earlobe.

Laser treatment

This can reduce the height and fade the colour of a keloid. It’s often used along with another treatment like a series of corticosteroid injections or pressure.

Silicone Sheets and Gels

These may be used along with pressure to prevent a keloid from returning. Sometimes, silicone is used alone to flatten a keloid. In one study, 34% of the raised scars had some flattening after patients used the silicone gel daily for six months.

Silicone gel sheets should be cut to fit the size of the keloid. The sheet is placed on the scar, taped into place, and left for 12 to 24 hours per day for two to six months. The sheet is washed daily and replaced every 10 to 14 days. Silicone gel may be used as an alternative to sheets in body areas where applying silicone sheets is impossible.

Cryotherapy

This treatment freezes the keloid from the inside out while saving the skin beneath the keloid. It’s used to reduce the hardness and size of a keloid. Cryotherapy works best on small keloids. Having a few cryotherapy treatments before (or after) receiving injections of corticosteroids may reduce the size of a keloid. This can make the injections more effective. Doctors have found that patients who have three or more cryotherapy treatments tend to get the best results.

Radiation Treatments

After your surgeon surgically removes the keloid, getting radiation therapy may prevent the keloid from returning. Patients may begin radiation treatments immediately after keloid surgery, the next day, or a week later. Radiation may also be used alone to reduce the size of a keloid. However, results tend to be better when used after keloid surgery.