Keloids are challenging to treat and often require a combination of approaches for optimal results. First-line treatments include corticosteroid injections, which can help reduce the size and thickness of the keloid. These are usually administered monthly for several months. While corticosteroid injections are widely used, they may be combined with other therapies to lower recurrence rates[1][3][6].
Other established treatments include:
- Pressure therapy: Using pressure dressings or garments, especially after surgery, can help prevent recurrence by minimizing blood flow to the site[1][6].
- Silicone gel sheeting or patches: These can flatten existing keloids or help prevent new formation after excision[1][5].
- Cryotherapy: Freezing keloids with liquid nitrogen may be effective for small lesions, often as an adjunct to steroids[1][4][6].
- Laser therapy: Pulsed-dye laser and other laser modalities can flatten keloids and reduce redness. Laser therapy is often combined with other treatments for improved results[1][3][6].
- Surgical removal: While surgical excision removes the keloid, it is generally not recommended as a standalone measure due to high recurrence (up to 100%). Surgery is best combined with adjunct therapies (pressure, silicone, radiation) to reduce risk of regrowth[1][3][6].
- Radiation therapy: Low-dose radiation, especially when applied within 24-48 hours after surgery, can reduce recurrence, but it carries the risk of skin complications and, rarely, long-term cancer[1][4][6][7].
- Topical and injectable agents: Agents such as fluorouracil (5-FU), bleomycin, verapamil, and botulinum toxin A have shown efficacy, either alone or in combination with corticosteroids and lasers[3][5][2].
The optimal treatment depends on the keloid’s size, location, and previous response to therapy. No single method guarantees permanent elimination, and recurrence is common, which is why combination therapy is often employed[2][3][5].
References
- [1] Keloid Treatments | Northwestern Medicine
- [2] Emerging and Novel Therapies for Keloids: A compendious review
- [3] Keloid treatments: an evidence-based systematic review of recent developments
- [4] Keloids > Fact Sheets > Yale Medicine
- [5] Management of Keloids and Hypertrophic Scars – AAFP
- [6] Keloid scar – Diagnosis and treatment – Mayo Clinic
- [7] Medical Treatment for Scars & Keloids | NYU Langone Health
Leave a Reply