George Woodbury MD 1/3/2023
From my perspective of over 30 years of practicing Dermatology, with Rheumatology and Dermatology Associates, Cordova, TN (www.Rheumderm.com. 1-901-753-0168), I have worked with many patients over the years with Keloids needing treatment. Let’s take a look at what Keloids are, what causes them, and Keloid treatment.
First, a Keloid is a type of excess scar tissue that can develop after an injury to the skin, but sometimes without a known trigger factor. Keloids are to be distinguished from what are called Hypertrophic Scars, because a Keloid goes outside of the original wound to the skin, whereas a Hypertrophic Scar stays within that bed.
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Keloids are especially prone to develop on the chest and back, but can also occur on the extremities and the even the face or scalp, sometimes two to four weeks after a type of injury occurs to the skin. Though more prone to occur among African-Americans and Asians, Keloids can develop in any racial group, and at any age.
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Keloids can be bothersome, because they frequently become itchy and sometimes even painful, or they can throb. Fortunately, a number of treatment approaches can be helpful in promoting Keloids to subside and to heal.
Dermatologists often start treating Keloids with what are called intralesional steroid injections, a management option that often has two be done every two to four weeks for three to six treatments, hopefully causing the Keloid to become softer and more management to treatment with is called topical steroid prescription cream or ointment.
Sometimes Dermatologic Surgeons consider actual surgical removal of Keloid. This surgical removal is often a more practical option for larger Keloids, or Keloids that have been present for months or years. There is however always a risk that the Keloid will grow back, meaning that we often also have to schedule the patient for at least three intralesional steroid injections, to reduce the risk of the Keloid growing back.
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Another treatment option for Keloids is radiation therapy, an approach that often has to be done at least 3 times a week for at least 6 weeks. This radiation therapy option is available in most metropolitan areas through referral centers.
Another management option for Keloids is use of topical silicone gel or silicone sheeting, which can be applied as a type of patch to the area of the scar. Silicone sheeting is available from a number of suppliers, or it can be ordered through many pharmacies.
So the good news about Keloids is that medical research has uncovered many Keloid treatment options treatments that have promise in healing them. The bottom line though is that all of these Keloid therapies require the supervision of a Dermatologist, and it often takes weeks or months of working on the problem to achieve resolution.
My own Dermatology practice since 1993 has been with Dermatology and Rheumatology Associates, 8143 Walnut Grove Road, Cordova TN 38018 (www.Rheumderm.com, 1-901-753-0168). Or you can find a Dermatologist closer to you by going to the American Academy of Dermatology web site, www.AAD.org, then plugging your zip code into the “Find a Dermatologist” tab.