Managing Keloids: Steroid Injections and Side Effects

Keloid frustration

I went to the dermatology department for keloids on my chest, and the doctor said that steroid injections could help reduce them.
I received injections for three consecutive weeks.
However, when I switched doctors in the fourth week, the new doctor informed me that there would be a duration of effect and suggested that I wait and see how things develop before considering further injections.
Subsequently, I noticed that the surrounding area appeared somewhat indented, and there was an additional blue, vein-like indentation that looks very unattractive.
Is there a way to address this side effect?

Tr, 30~39 year old female. Ask Date: 2020/01/26

Dr. Wu Yuxin reply Dermatology

I cannot identify the lesion, so it's best to consult your attending physician, as they are most familiar with your condition.

Reply Date: 2020/01/26

More Info

Keloids are a type of raised scar that occurs when the body produces too much collagen during the healing process. They can be itchy, painful, and often appear larger than the original wound. Managing keloids can be challenging, and one common treatment option is the use of steroid injections, which aim to reduce inflammation and collagen production in the scar tissue.

Steroid injections, particularly corticosteroids, are frequently used to treat keloids. The goal of these injections is to flatten the keloid and reduce its size over time. Typically, a healthcare provider will administer these injections every few weeks, and the treatment may continue for several months depending on the keloid's response. While many patients experience improvement, there are potential side effects associated with steroid injections.

One of the most common side effects of steroid injections is skin atrophy, which can lead to thinning of the skin in the treated area. This may result in a sunken appearance or a change in skin texture, which could explain the "凹痕" (depression) you noticed after your treatments. Additionally, the appearance of bluish or purplish discoloration, resembling a blood vessel, can occur due to changes in the skin's structure or blood flow in response to the steroid treatment.

Other potential side effects of steroid injections include:
1. Hypopigmentation: Lightening of the skin in the treated area, which can be particularly concerning for individuals with darker skin tones.

2. Pain or discomfort: Some patients may experience pain at the injection site, which usually subsides shortly after the procedure.

3. Infection: Although rare, there is a risk of infection at the injection site.

4. Recurrence of keloids: In some cases, keloids may return after treatment, necessitating further interventions.

If you are experiencing significant side effects such as the depression and discoloration you described, it is essential to discuss these concerns with your dermatologist or healthcare provider. They may recommend several options to address these side effects, including:
- Topical treatments: Creams or ointments containing silicone or other ingredients may help improve the appearance of the skin and reduce the visibility of the keloid.

- Laser therapy: This can be used to improve the texture and color of the skin, potentially reducing the appearance of the depression and discoloration.

- Surgical options: In some cases, surgical removal of the keloid may be considered, although this carries a risk of recurrence.

- Compression therapy: Wearing pressure garments can help flatten keloids over time.

It is crucial to have an open dialogue with your healthcare provider about your treatment plan and any side effects you experience. They can help tailor your treatment to minimize side effects while effectively managing your keloid. Remember that keloid treatment often requires a multi-faceted approach, and patience is key, as results may take time to become apparent.

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