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A keloid is shiny, firm and rubbery scar that may be flesh-toned, pink, red or dark brown in color. Keloid scars can itch and may be painful. Depending upon their location, such as over a joint, they can inhibit full range of motion.
Unlike hypertrophic scars, which are raised scars, a keloid scar can grow beyond the boundaries of the original wound.
How is a keloid treated?
There is no completely effective treatment for keloids. Unfortunately, even after surgically removing them, there is a 50% chance that the new wound will develop a keloid scar and that the new scar may grow even larger. Our dermatologists, Dr. Schwedelson and Dr. De Araujo, are familiar with keloid scars, and have several options to treat them.
One non-invasive option is the use of silicone dressings. These moist wound coverings made of silicone gel can reduce keloid scars, though it takes time for results to become apparent. This method works by limiting the growth of fibroblasts and collagen in order to prevent more scarring.
Compression bandages, like those used for burn patients, have been used to reduce the size of keloid scars. As with silicone dressings, this option may require a prolonged treatment period of 6-12 months before change is noted.
Steroids injected into the keloid scar have been shown to reduce keloid size and are currently the gold standard of care.
Radiation therapy can be effective when performed immediately following scar revision surgery.
Laser therapy, combined with steroid injections and silicone sheeting or compression can be effective.
Chemotherapeutic agents can be injected into keloids and has been shown to be effective in reducing their size in some cases
Cryosurgery can be effective on small keloids that occur on lightly pigmented skin. It is often combined with cortisone injections. Cryotherapy creates an area of frostbite, resulting in sloughing off of the damaged skin along with the keloid scar.
As mentioned above, surgery can be done to excise the scar, but the unfortunate challenge is the propensity of the scar to return, often bigger than before. Often, a combination of surgical removal and/or laser treatments immediately followed with injections of steroids into the scar can help avoid another keloid formation.