New Treatments for Keloids: Options Beyond Steroid Injections - Plastic Surgery

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Keloids, also known as hypertrophic scars, are raised areas of scar tissue that develop when the body produces too much collagen during the healing process. They can be particularly distressing when they occur on visible areas of the body, such as the face, as they can be both unsightly and uncomfortable. Traditional treatments for keloids often include steroid injections, which aim to reduce inflammation and flatten the scar. However, many patients seek additional options, especially when they are concerned about the appearance of their scars.

There are several treatment options available for keloids beyond steroid injections. Here are some of the most common and effective methods:
1. Silicone Gel Sheets and Silicone Gel: These are often used as a first-line treatment for keloids. Silicone gel sheets can be applied directly to the scar and worn for several hours a day. They work by hydrating the scar tissue and creating a protective barrier that can help flatten the keloid over time. Silicone gels are similar but can be easier to apply and may be more comfortable for some patients.

2. Cryotherapy: This treatment involves freezing the keloid with liquid nitrogen. Cryotherapy can help reduce the size of the keloid and may also alleviate some of the associated itching or discomfort. However, multiple sessions may be required, and there is a risk of skin discoloration.

3. Laser Therapy: Various types of laser treatments can be effective for keloids. Pulsed dye lasers can help reduce redness and flatten the keloid, while fractional laser therapy can improve the texture and color of the scar. Laser treatments are often used in conjunction with other therapies for optimal results.

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

5. Radiation Therapy: This is sometimes used after surgical removal of a keloid to prevent recurrence. Low-dose radiation can help inhibit the growth of scar tissue. This treatment is typically reserved for more severe cases due to the potential risks associated with radiation exposure.

6. Intralesional Treatments: In addition to steroids, other medications can be injected directly into the keloid. These may include 5-fluorouracil (5-FU), which is a chemotherapy agent that can help reduce the size of the keloid, or interferon, which can modulate the immune response.

7. Pressure Therapy: Applying consistent pressure to the keloid can help flatten it over time. This is often done using custom-made pressure garments, especially for larger keloids.

8. Alternative Treatments: Some patients explore alternative therapies, such as acupuncture or herbal remedies. While there is limited scientific evidence supporting these methods, some individuals report subjective improvements.

It's important to consult with a dermatologist or a plastic surgeon who specializes in scar management to determine the best treatment plan for your specific situation. They can assess the keloid's characteristics, your skin type, and your overall health to recommend the most appropriate options. Additionally, they can help set realistic expectations regarding the outcomes of treatment.

In conclusion, while steroid injections are a common treatment for keloids, there are numerous other options available that can help improve the appearance of scars. Each treatment has its own benefits and risks, and a tailored approach is often the most effective way to manage keloids and achieve satisfactory results.