Keloids are raised scars that extend beyond the original wound site. They form due to excessive collagen production during healing, resulting in firm, smooth, and often rubbery growths. Unlike hypertrophic scars, which stay within the injury site and may resolve, keloids persist and can enlarge. While treatment can improve their appearance, the process is complex, and keloids have a strong tendency to recur.
Is Keloid Removal Possible?
Physical removal of a keloid, such as through surgery, is an option but rarely a standalone solution. Removing a keloid without additional therapies often leads to the scar growing back, sometimes larger. This is because the biological factors causing keloid formation, like collagen overproduction, often persist. Therefore, treatment goals extend beyond simple removal to managing symptoms and, importantly, preventing recurrence. Effective management typically combines different therapies for better outcomes and reduced regrowth.
Common Treatment Approaches
Various methods address keloids, often used in combination. Surgical excision removes the keloid, effective for larger lesions. However, its high recurrence rate (45-100% when used alone) necessitates follow-up treatments. Combining surgery with other therapies immediately after significantly lowers this risk.
Corticosteroid injections are a widely used approach. These injections deliver steroids directly into the keloid, reducing inflammation and suppressing collagen overproduction. They can flatten and shrink keloids by 50% to 80% and are often used before or after surgery, or as a primary treatment.
Cryotherapy involves applying extreme cold, often liquid nitrogen, to freeze and destroy keloid tissue. This method causes cell death and gradual breakdown of the scar. It is particularly effective for smaller keloids and can lead to a flatter, less prominent scar.
Laser therapy utilizes concentrated light beams to target keloid tissue. Certain lasers can reduce redness and flatten the scar by targeting blood vessels, while others vaporize the outer layers, improving texture and size. Lasers can improve appearance and are often combined with other treatments, like steroid injections, to enhance results.
Radiation therapy uses low-level X-ray radiation to inhibit cell proliferation and prevent regrowth. Typically applied immediately after surgical removal, this adjuvant treatment significantly reduces recurrence rates compared to surgery alone, with reported rates as low as 10-20%.
Non-invasive options include silicone sheets and pressure garments. Silicone products help flatten keloids and prevent recurrence by maintaining hydration and regulating collagen production. Pressure therapy, involving constant pressure, can reduce oxygen tension in the tissue, slowing collagen production, and is especially effective when worn consistently for several months.
Preventing Keloid Recurrence
Keloids are prone to recurrence because the body’s healing response, which caused the initial overgrowth of collagen, can be re-triggered by new injury or treatment. Therefore, successful long-term management relies on a multi-faceted approach, often combining therapies to interrupt this cycle. For instance, surgical removal is frequently followed immediately by treatments like corticosteroid injections or radiation therapy to suppress scar tissue formation.
Ongoing use of silicone products, such as gels or sheets, is a common post-treatment strategy to hydrate scar tissue and modulate collagen production. Pressure therapy, applying consistent pressure, also helps flatten the scar and reduce regrowth. Meticulous wound care after any procedure, including protecting the area from trauma and sun exposure, is crucial to minimize recurrence triggers.
Consulting a Specialist
Given the complex nature of keloids and their tendency to recur, seeking professional medical advice is important for diagnosis and treatment. Consulting a dermatologist or plastic surgeon specializing in scar management is advisable. These specialists can distinguish keloids from other scar types, such as hypertrophic scars, which require different management strategies.
A personalized treatment plan is crucial, as effectiveness varies based on the keloid’s size, location, and the person’s skin type. During a consultation, discuss all available treatment options, their benefits, risks, and realistic expectations regarding recurrence. An informed discussion with a healthcare provider ensures a tailored approach for successful keloid management.