Treatment Options

Keloids are chronic skin conditions that require a comprehensive treatment plan and approach. Most keloids need more than one modality of treatment. Approach to treatment of keloids is to design a step by step non surgical treatment plan for every patient. This plan should take into consideration the location, size and thickness of the keloid as well as the associated symptoms. Some keloids can be treated with cryotherapy alone, others need to be injected with steroids first and, if they do not respond to this treatment, cryotherapy is used in the second stage. If all these fail, one may need to even incorporate surgery, as a step to gain control over the process. Although Keloids are difficult conditions to treat, the good news is that everyone with Keloids can be helped in one form of treatment or the other. Treatment of heavy scars and keloids take time. Each treatment results in some improvement in the appearance of the keloid. In most patients, treatment needs to be repeated to achieve best results.

INTRALESIONAL INJECTIONS

An easy and common method of treating keloid is to inject the site of the disease with either steroids or chemotherapy drugs, if steroids don't work. Injecting keloids do work in some patients. Injections need to be repeated several times.

SURGERY:

Surgery and removal of the keloid from the skin does result in immediate improvement in the appearance of the skin, however, the risk of recurrence after surgery is near 100%. Surgery alone does not and cannot cure any keloids, and at times, it makes the situation worse by re-growth of an even bigger keloid at the site of surgery.

CRYOTHERAPY:

The fundamental approach to treatment of keloids is to destroy the keloid tissue with a method that results in the least chance of recurrence. Cryotherapy has been used with success in treatment of various keloids. Medical literature supports usage of Cryotherapy for this condition. In 1993, Italian physician Dr. Rusciani published his experience with 65 Keloid lesions (J. Dermatology Surg Oncol., 1993. Jun 19 (6): 529-34. Use of cryotherapy in the treatment of keloids) and concluded that: "Cryotherapy is an effective, low risk approach to keloid treatment associated with a low rate of recurrence. In 2005, Dr. Fikrle, from Czech Republic, published his experience with cryotherapy as monotherapy (that is just using cryotherapy, without any other interventions) in seven cases of earlobe keloids (Dermatol. Surg., 2005. Dec 31 (12):1728-3). Dr. Fikrle observed that the volume of the keloids reduced in every patient and that complete flattening of the scars/keloids occurred in five out of seven patients and concluded his publication, stating: "We present an excellent effect of cryosurgery as the monotherapy for the treatment of earlobe keloid scars of young patients."

RADIATION THERAPY:

Radiation therapy can cause regression of some Keloids, however some Keloids that are treated with radiation therapy will not resolve. Skin may form a new, and at times worse scarring at the site of radiation. Radiation can also cause fibrosis and very dense skin reaction at the site of treatment. Chronic infections and skin abscess formation are among other long term complications of radiation therapy for Keloids. Long term carcinogenic and other risks of radiation therapy do not justify using radiation in the treatment of Keloids.