Keloid Scars Part II

Can you prevent keloid scars?

People who developĀ keloid formations from wounds are more unfortunate because of the current limited options. A person who knowingly has this predisposition should pay more attention to wound care including cleanliness and dressings. Since even minor injuries that are not traumatic like insect bites or small cuts, as well as, folliculitis from shaving and acne can lead to keloid formation it is imperative to be fastidious in caring for the skin. Following the best advice of the physician overseeing ones care is paramount.

People with the propensity to keloid should avoid:

  • body piercings
  • tattooing

These are unnecessary risks. Include your predisposition to keloid scar formation as part of your permanent medical record so any surgeon can be aware of it.

Surgical treatment of keloid scars

Until recently surgical intervention to reduce keloid scars have been proven to be 50% effective. Surgical treatment whether by knife of laser yields the same level of result. The overriding issue is that the recurrence of keloid formation from the surgical scar is very possible; recent developments of a cryrotherapuetic approach is yielding some amazing new results (see video).

Non surgical treatments for keloid scars

Non surgical treatment such as Inteferon therapy has proven to be effective at reduction of keloid scars. Interferon therapy is a drug intervention that acts on the immune system. Inherently this comes with side effects that physicians must share with patients:

  • toxicity
  • flu like symptoms
  • Depression
  • nausea and vomiting

There are other non surgical interventions that are being employed with varying results:

  • anitihistamines and vitamins
  • nitrogen mustard applications
  • Verapamil (L-type calcium channel blocker)
  • Retinoic acids (ATRA) a trace nutrient derived from Vitamin A

Theoretically compression can be used to soften and break up the keloid tissue but location of the keloid can limit this option.

Combined treatments for keloid scarring

One option involves surgical removal of scar tissue in combination with a couple of steroid injections -one at the time of the surgery and the second injection about 3 to 4 weeks later. However, this type of treatment is variously reported as having between a 50% to 70% rate of recurrence.

Another option combines surgery with external type radiotherapy. Radiation has the effect of interfering with skin growth (fibroblasts) and collagen production. Research varies on which type of combination therapy is the more effective. Both radiotherapy and steroid drugs have side effects so you need to discuss with your doctor the most effective. It may be worth getting a second opinion before proceeding with either treatment.