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Why does keloid scars form and how to minimize them (Part II)

Treatment of keloid scars may be challenging and some patients may need more than one treatment option; others may need to repeat the treatment more than once. The available treatment options may include:

  • Compression garments: the idea behind wearing compression garments is that these garments apply continuous pressure on the keloid scar which will help to flatten and improve the scar appearance. It is important to wear these garments in the early stages of scar formation as the scar will respond better when the compression garments are used since the beginning were the scar is still fresh and immature. Compression garments should not be loose and should be worn for 23 hours a day and taken only when bathing and during dressing change. Burned patients may be asked to wear the garments for years. Ask your treating physician for how long you should wear them.
  • Surgery: surgical removal of keloids was traditionally recommended however, there is a high incidence of recurrence of the keloid scar (50%-100%) if surgery is not combined with other modalities of treatment. The recurrent keloid may be larger and more severe than the original one that was present. Surgical removal is done by excising the keloid and suturing the area to help close the wound or using skin graft is the area is big combined with another method such as silicone gel.
  • Steroid injection into the scar: it is considered as a mainstay for both treatment and prevention of recurrence. The way steroid injection works is by promoting the breakdown of collagen fibers and decreasing the inflammation which will help flatten the scar and make it less tender. An example of steroid injection is Triamcinolone.
  • Applying steroid impregnated tape to the area of keloid for 12 hours a day. Avoid applying the tape on the normal skin as it may cause thinning of the normal skin.
  • Applying silicone gel sheeting or dressing to the keloid area: this method may be used as an alternative to the injection of steroid. This method should be used for several months however, there is limited evidence to suggest its effectiveness to treat or prevent keloid scars.
  • Laser therapy: this method is usually used in combination with steroid injections to get the best results possible. Using laser usually decreases the redness of the scar, make it more smooth or flat without affecting the size of the scar.
  • Cryotherapy: this is done by freezing the keloid using liquid nitrogen at an early stage to prevent it from growing and getting bigger.
  • Radiotherapy: this method uses low dose superficial radiotherapy, it is mainly used to prevent the recurrence of severe keloid scars.
  • Medication: such as 5- fluorouracil, interferon and bleomycin.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.