Keloids are an over growth of scar tissue. Anytime skin is injured, cut, burnt or traumatized, the result is a scar. In most people, the scar is limited. However, in some people the scar continues to have exaggerated growth. Keloids commonly occur after tattoos, ear piercing, acne, ingrown hair and even minor trauma. In most cases, the trauma is so minor that one does not realize it and yet the body’s response is an ugly-looking large scar. However, the most common cause of keloids is after surgery. Keloids usually appear raised, thick, irregular and always have a poor cosmetic appearance.
Who is prone to keloids?
African American, Asians and Middle Easterners are prone to Keloids. Why this occurs is not understood. These same individuals also have a tendency to have recurrent Keloids.
How does one treat keloids
No matter what any doctor or surgeon claims, Keloids are very difficult to treat. Despite the glut of treatments, there is no satisfactory treatment and in fact, the majority of available treatments make Keloids appear worse than the original scar.
One of the most common treatments for Keloids is injection of potent corticosteroids into the scar tissue. The number of injections vary but most individuals require at least 3-6 injections spaced over 4-6 months. The success rate of corticosteroids is about 50-60 percent. The results are better for small scars but at least 40% see no benefit.
Surgical removal of Keloids is the least recommended treatment. In almost all cases, the resultant scar is many times worse than before. Other treatments include laser, compression garments, electrodessication (heating) and cryotherapy (cooling). Except for laser, none of the other treatments work well. Even though the laser does work, there is no guarantee that the Keloid will not come back. On average about 50-70 percent of individuals do see some benefit from laser. While laser is the preferred treatment, it is also very expensive, painful and there is no guarantee that it will work.
In the last decade, novel dressings and compression garments have also been used to treat Keloids. However, these treatments do not work instantly and have to be applied for long periods. In addition, these treatments are very expensive and the results are mediocre at best.
A relatively new treatment for Keloids has been the use of drugs like imiquimod, bleomycin or interferon. These potent drugs work by stopping cell growth and decrease size of scar. However, very few reports exist about efficacy of these treatments. Moreover, these chemicals also have nasty side effects that include burning, stinging and intense pain. These last resort treatments should only be done when all other treatment modalities have failed.
Final Point
Anyone with Keloids who wants treatment should avoid surgery at all costs. If you do undergo any type of treatment, be realistic and start with corticosteroid injections. If that fails, search for a competent health professional who has experience with the more invasive methods and is affordable.
