Keloid Scars

Keloid Scars; At A glance

  • Best Results2-8 sessions
  • Treatment Recovery0 days
  • Procedure Time5 minutes
  • Skin SpecialistDavin Lim, Dermatologist
  • Duration of ResultsLong term
  • AnaestheticNumbing + local blocks
  • Back to WorkImmediately
  • Cost$

Keloid Scars

Keloid scars are commonly found on the chest, shoulders, back & jawline. Fortunately, the majority of scars can be treated with simple injections & lasers. Keloids are more common in younger adults. Prevention is the key to long term management.

FactsFacts on Keloid Scars

  • Keloid & hypertrophic scars are due to excessive collagen formation
  • Keloids are more common in ethnic skin types, including Asians & Africans
  • The most common secondary cause is acne & surgery
  • Keloids can occur after piercings or trauma
  • Keloids are often itchy, occasionally they may be painful
  • Non-surgical options include silicone gel, lasers, anti-inflammatory injections, freezing, surgery & radiotherapy
  • The majority of cases respond to simple injections, spaced 6 to 10 weeks apart
  • Typically a series of 2 to 10 injections are required

What is a keloid scar?

Scars can be raised (hypertrophic or keloid scars), or they can be depressed (atrophic scars). Keloid scars extend beyond the margin of the injury, whilst hypertrophic scars are within the scar itself. Keloids can be itchy, painful or asymptomatic.

The most common locations for keloid scars are the chest, shoulders, back, ear, jawline & areas of surgical scars.

Why do keloids people get keloids?

Keloids & hypertrophic scars are common in young people. They are due to excessive collagen production, resulting in a raised scar. Keloids by definition extend beyond the boundary of the scar. Trauma (such as ear piercings) can predispose patients to keloid scars. Other risk factors for keloids include –

  • Gender. Females are more likely to get keloid scars.
  • Ethnicity, more commonly seen in Asian and darker skin types.
  • Age. Collagen production is accelerated in younger people compared to older patients
  • Inflammation & location; pressure areas such as the shoulders, back & chest areas are more prone to scarring, including areas prone to acne
  • Thermal injury such as burns can elicit an exaggerated healing response.
  • Surgical wounds including excision of moles & C-sections

What can you do before seeing a dermatologist?

The most important aspect of management is to prevent other keloids from forming. This means if you have active acne, control it. Discuss with your GP methods to do this.

You can try silicone dressings such as Stratagel or another silicone gel; ask your pharmacist as to what they stock.

What treatments are there for keloid scars?

Keloids scars can respond to lasers & injections. It is advisable to trial a series of these treatments before more radical procedures including surgery & radiotherapy. Treatment options include-

  • Steroid injections. These are usually repeated at 6-8 weekly intervals.
  • 5FU or chemotherapy injections. Repeated 6-8 weeks apart.
  • Cryogen or cryoprobe, often in conjunction with steroid injections.
  • Botox; this has been reported in the literature (low success rate).
  • Silicone gel or sheeting, good as a prevention (Stratamark)
  • CO2 fractional laser; in combination with anti-inflammatory steroids
  • Microneedling with steroid drip
  • Vascular laser +/- anti-inflammatory injections
  • Radiotherapy (fractionated, 4-10 sessions)
  • Verapamil or Bleomycin injections

The ideal treatment will depend on the location of the scar, the size, your age & your past treatment (failures). In the majority of cases, steroid injections are the first step.

Davin’s take on keloid scars

This phenomenon is super common, especially in ethnic patients. The typical profile is as follows- young patients, darker skin types, female, sites include chest, back, shoulder, jawline & ears. Early lumps can be prevented with simple silicone gel, taping & pulsed anti-inflammatory ointments.

keloid-treatment-brisbane

When patients see me, my usual treatment is with intralesional corticosteroids injections. This may be effective for small to medium keloids. I also use 5FU injections as well as vascular & CO2 fractional laser resurfacing for larger lesions.

In severe/recurrent cases postoperative fractionated radiotherapy can be useful, usually after surgical excision. If you have ear keloids my usual treatment is excision followed by 4 to 6 months of pressure earrings. If you are prone to have exaggerated scarring elsewhere. Notify your doctor (or tattoo artist) prior to any procedure.

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