Effective Treatments for Keloids: Solutions for Scarring After Injury - Plastic Surgery

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Keloids, also known as hypertrophic scars, are raised areas of scar tissue that develop at the site of an injury. They can be particularly frustrating for patients, especially when they do not respond well to topical treatments. In your case, having developed keloids after an injury from a car accident, it’s understandable that you are seeking effective treatments to manage and reduce the appearance of these scars.


Understanding Keloids
Keloids occur due to an overproduction of collagen during the healing process. They can be itchy, painful, and may continue to grow beyond the original injury site. Keloids are more common in individuals with darker skin tones and can be influenced by genetic factors. Unfortunately, they can be resistant to treatment, making management challenging.


Treatment Options
1. Topical Treatments: While you mentioned using various ointments with limited success, it’s important to note that topical treatments like silicone gel sheets or silicone ointments are often the first line of defense. These products can help flatten keloids over time, but they require consistent application over several months to see results.

2. Injections: Corticosteroid injections are commonly used to reduce the size and symptoms of keloids. These injections can help flatten the keloid and reduce itching or discomfort. Multiple sessions may be required, and the effectiveness can vary from person to person.

3. Cryotherapy: This treatment involves freezing the keloid with liquid nitrogen. Cryotherapy can help reduce the size of the keloid, especially when combined with corticosteroid injections. However, it may not be suitable for all patients and can sometimes cause changes in skin pigmentation.

4. Laser Therapy: Laser treatments can be effective in reducing the redness and size of keloids. Different types of lasers can be used, and the choice depends on the specific characteristics of the keloid. This treatment may require multiple sessions and can be combined with other therapies for better results.

5. Surgical Removal: In some cases, surgical excision of the keloid may be considered. However, this option carries the risk of the keloid returning, sometimes even larger than before. To mitigate this risk, surgeons often recommend combining surgery with other treatments, such as corticosteroid injections or radiation therapy, immediately after excision.

6. Radiation Therapy: Post-surgical radiation therapy can be an effective way to prevent keloids from returning after surgical removal. This treatment is typically used in conjunction with surgery and is more common in severe cases.

7. Experimental Treatments: Newer treatments, such as the use of 5-fluorouracil (5-FU) injections or imiquimod cream, are being studied for their effectiveness in treating keloids. These treatments may not be widely available and should be discussed with a dermatologist.


Lifestyle and Home Remedies
In addition to medical treatments, there are some lifestyle changes and home remedies that may help manage keloids:
- Avoiding Irritation: Protect the keloid from friction and irritation, which can exacerbate its appearance.

- Sun Protection: Use sunscreen on the keloid to prevent hyperpigmentation, as sun exposure can darken the scar.

- Moisturization: Keeping the area moisturized can help improve the overall appearance of the skin.


Conclusion
Managing keloids can be a long and sometimes frustrating process, but there are multiple treatment options available. It is crucial to consult with a dermatologist or a plastic surgeon who specializes in scar management to determine the best course of action tailored to your specific situation. They can provide guidance on the most effective treatments based on the characteristics of your keloids and your overall skin type. Remember, patience and consistency are key in achieving the best results.