Effective Treatments for Keloids: Beyond Steroid Injections - Dermatology

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Keloids, or hypertrophic scars, can be a significant concern for many individuals, particularly when they cause discomfort or aesthetic issues. Your inquiry about effective treatments beyond steroid injections is very relevant, as keloids can be challenging to manage. Here’s a comprehensive overview of treatment options and considerations for keloids.


1. Understanding Keloids and Their Symptoms
Keloids are raised scars that occur due to an overproduction of collagen during the healing process. They can be itchy, painful, and may change color over time. The symptoms you describe, such as itching and discomfort during physical activity, are common among individuals with keloids. This can be particularly bothersome, as keloids can be sensitive to pressure and movement.


2. Treatment Options Beyond Steroid Injections
While steroid injections are a common first-line treatment for keloids, there are several other options available that can help reduce their appearance and alleviate symptoms:
- Silicone Gel Sheets or Silicone Gel: These are often recommended for managing scars, including keloids. Silicone has been shown to hydrate the scar tissue and may help flatten the keloid over time. Look for products that contain silicone as a primary ingredient, as they are clinically proven to be effective.

- Cryotherapy: This involves freezing the keloid with liquid nitrogen, which can help reduce its size. Cryotherapy is often used in conjunction with other treatments, such as steroid injections, to enhance effectiveness.

- Laser Therapy: Laser treatments can help reduce the redness and thickness of keloids. Different types of lasers can be used, including pulsed dye lasers for redness and fractional lasers for texture improvement.

- Surgical Removal: In some cases, surgical excision of the keloid may be considered. However, it’s important to note that surgery can sometimes lead to the formation of new keloids, so it is often combined with other treatments, such as steroid injections or radiation therapy, to minimize this risk.

- Radiation Therapy: Post-surgical radiation therapy can be effective in preventing keloid recurrence. This treatment is typically used in conjunction with surgical excision.

- Interferon Therapy: This is an injectable treatment that can help reduce keloid size and is sometimes used for patients who do not respond to other therapies.


3. Managing Pain and Discomfort
Regarding the pain you experience after steroid injections, it is not uncommon for patients to feel soreness at the injection site. This can sometimes radiate to surrounding areas, especially if the keloid is large or if multiple injections are given. If the pain persists or worsens, it is essential to discuss this with your healthcare provider, as they may need to adjust your treatment plan.


4. Recommended Scar Treatment Gels
When it comes to scar treatment gels, silicone-based products are highly recommended. They are effective in flattening and softening scars. Look for products that specifically mention they are designed for keloids or hypertrophic scars. Some popular options include:
- Mederma Advanced Scar Gel: Contains allantoin and is designed to improve the appearance of scars.

- Kelo-cote: A silicone gel that forms a protective barrier over the scar.

- Bio-Oil: While not silicone-based, it contains a blend of oils and vitamins that can help improve scar appearance.


Conclusion
In summary, managing keloids effectively often requires a multifaceted approach. While steroid injections can provide some relief, exploring additional treatments such as silicone gel, cryotherapy, laser therapy, or even surgical options may yield better results. It is crucial to have an open dialogue with your healthcare provider about your symptoms and treatment preferences to develop a personalized plan that addresses both the physical and emotional aspects of living with keloids.