Treatment Options for Keloid Scars
Corticosteroid injections (intralesional steroids)
These are injections that cause a moderate amount of pain but are intended to flatten the scar. The injections are given every 4-8 weeks, which can cause redness around the wound site. The redness can then be treated with a laser to reduce the color. Unfortunately, the keloid scar may look better, but the injection typically leaves a mark from the inserting the needle.
This is obvious – it’s the process of cutting out the keloid scar. As you might expect, this can be risky because it can cause a larger keloid scar to form. There are usually far better options than surgery, but sometimes it’s necessary. After surgery, compression is applied to the wound site for several months to reduce the chance of the keloid scar reforming.
A pulsed-dye laser can be used to flatten the scar and to reduce redness. This is an extremely safe operation. The only real downsides are that you may need to undergo several treatments and the cost can be quite high. Most insurance plans won’t cover this type of procedure because it’s considered to be an elective procedure.
Silicone Gel or Sheeting
This is the process of wearing a sheeth or sheet of silicone over the affected area continuously for months. As you can imagine, this can be difficult to do, especially for children. This treatment option is rarely used.
This is like the process of applying silicone, except it’s simply the process of applying pressure to the wound site. This is typically done in conjunction with other types of treatments like surgery, laser and injections.
Cryotherapy is occasionally used to freeze the keloid scar. Liquid nitrogen is used to flatten the scar. However, this can cause the scar to darken, which will require further treatment by laser.
The body produces interferon to fight off viruses and bacteria. This can be injected into the body to reduce keloid scars. Another option is to apply a topical ointment called Aldara to stimulate the body to produce interferon. It’s uncertain whether the results last.
Doctors have used radiation to treat keloid scars for several decades. Due to the risk of the radiation causing malignant tumors, however, the use of radiation has greatly diminished.
Doctors generally use two basic types of radiation — either internal brachytherapy or external electron beam irradiation.
Generally, internal radiation is more suitable for linear-shaped keloid scars or keloid scars in curved areas like the shoulder or knee areas. External radiation, on the other hand, is typically used when the keloid scar is large and bulky or smaller than 4 cm and in a relatively flat area of the body.