When to Consider Keloid Removal Surgery: A Guide for Patients - Dermatology

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Keloids, also known as hypertrophic scars, are raised areas of scar tissue that form at the site of an injury. They can be bothersome both physically and aesthetically, leading many patients to consider surgical removal. Understanding when to consider keloid removal surgery is crucial for patients who experience discomfort or dissatisfaction with their keloids.


When to Consider Keloid Removal Surgery
1. Persistent Growth: Keloids often stabilize after a certain age, typically around the late teens to early twenties. However, if you notice that your keloid continues to grow beyond this age, as you mentioned, it may be time to consult a healthcare professional. Continuous growth can indicate that the keloid is still active, and surgical intervention might be necessary.

2. Physical Discomfort: If your keloid is causing pain, itching, or discomfort—especially if it interferes with your daily activities or sleep—surgery may be warranted. For example, you mentioned that your keloid is painful when bumped and affects your ability to sleep on your side. These symptoms can significantly impact your quality of life.

3. Aesthetic Concerns: Many individuals seek keloid removal for cosmetic reasons. If the appearance of the keloid is affecting your self-esteem or body image, discussing surgical options with a dermatologist or plastic surgeon can be beneficial.

4. Location of the Keloid: Keloids located in areas prone to friction or trauma (like the chest, shoulders, or earlobes) may be more likely to cause issues. If your keloid is in a location where it is frequently irritated, surgical removal may help prevent further complications.


Types of Keloid Removal Surgery
1. Excision: This is the most common method for keloid removal. The surgeon will cut out the keloid tissue. However, excision alone can sometimes lead to recurrence, so it is often combined with other treatments.

2. Steroid Injections: After excision, steroid injections may be administered to reduce the risk of recurrence. These injections can help flatten the scar tissue and minimize inflammation.

3. Cryotherapy: This involves freezing the keloid with liquid nitrogen, which can help reduce its size. This method is often used in conjunction with surgical excision.

4. Laser Therapy: Laser treatments can help improve the appearance of keloids and reduce their size. This is often used after surgical removal to enhance the cosmetic outcome.

5. Radiation Therapy: In some cases, low-dose radiation therapy may be used after excision to prevent recurrence. This is typically considered for larger keloids or those that have recurred after previous treatments.


Post-Surgical Considerations
- Recovery Time: After keloid removal surgery, you may experience some swelling and discomfort. It’s essential to follow your surgeon's post-operative care instructions to promote healing and minimize the risk of recurrence.

- Monitoring for Recurrence: Keloids can recur even after surgical removal. Regular follow-ups with your healthcare provider can help monitor for any signs of regrowth.

- Alternative Treatments: If surgery is not an option or if you prefer to explore other avenues, treatments such as silicone gel sheets, pressure therapy, or continued steroid injections may be recommended.


Conclusion
In summary, if your keloid is growing, causing pain, or affecting your quality of life, it may be time to consider surgical removal. Consult with a dermatologist or a plastic surgeon who specializes in scar management to discuss your options. They can provide a tailored approach based on the size, location, and characteristics of your keloid, as well as your personal preferences and health history. Remember, early intervention can often lead to better outcomes, so don’t hesitate to seek professional advice.