Keloid- Celina, Intra-lesional Steroid Injections

Keloid is a special form of chronic, non-malignant tumor that forms at the site of skin injury or on people who have recently gone through various surgeries like cardiac, orthopedic, obstetrics, gynecological or plastic surgery. Acne and chickenpox scars, ear piercing, burns and other skin injuries can also form these type of scars. Keloids can be defined as different types of typical wound recovering. In a typical wound, after the injury or surgery, the metabolic activities completely balance out within 6-8 weeks. When the balance between the production of collagen and breaking down of the collagen is hampered, during the recovery process, a scar starts developing. This keeps on spreading to form a keloid or a hypertrophic scar where the skin gets thickened and turns reddish making it highlighted, with the surrounding skin areas. However, keloids do not cause any physical pain but can definitely be the cause of embarrassment.

What Causes Keloid?

The exact cause for the formation of keloid is unknown. It can grow after acne spots and boils, burns, lacerations, body piercings and surgical wounds. It is assumed that the cells called fibroblasts are responsible for the production of scar tissue.  Hormonal problems, a disorder of the immune system and some genetic factors may be the leading factors for the formation of keloids.

Treatment Options for Keloid

A keloid scar may heal over time but it is very rare that the scar disappears completely. However, there are various treatments that are available to treat keloid scars. It should be noted that no treatment is cent percent effective and the patients may be offered a combination of different methods. Results may vary from person to person.

Airtight (occlusive) dressings- It is a special type of dressing which applies pressure and/or prevents air from coming into direct contact with the scar. This must be used for 12-24 hours a day for the first few weeks. Materials used are silicone as a gel,  impregnated sheet or polyurethane self-adhesive patches. Compression earrings are recommended for keloids, due to earlobe piercings. Once the original keloid has been removed by surgery, the compression dressings must be worn for 24 hours a day.

Corticosteroid injections (intralesional steroid injections): Almost all keloids respond to injection of a steroid called triamcinolone when injected into the scar. Injections are given periodically every 2-6 weeks until noticeable improvement is observed. These are considered as a safe procedure, but candidates may experience slight pain. The injections are generally given once in every four to six weeks into the keloids, which helps to flatten the keloids. However, it is observed that steroid injections can stimulate the formation of more superficial blood vessels in the sparring area. The keloid will definitely look better after a single treatment, but even the best results will leave a mark that will appear quite different from the surrounding skin.

Interferon: Human body immune system produces some proteins called interferons that help fight viruses, bacteria, and other enemy attacks. In recent studies and experiments, it is found that interferon injections can reduce the size of keloids effectively. But this is not yet certain, whether the effect will be long-lasting. Currently, several types of research are being executed by applying topical imiquimod (Aldara), which stimulates the body to produce interferon.

Surgery: Surgery is always risky as cutting a keloid can escalate the production of a similar or even larger keloid. Some surgeons may achieve success in a surgical procedure to eliminate keloids, but the procedure mostly follows by applying compression dressing to the wound for several months after eliminating the keloid from the affected area. Superficial radiation treatment is also marked as one of the most effective treatment after undergoing a surgical excision method.

Laser: a specialized pulsed-dye laser is used to treat keloids that flattens the keloids and makes them look less red than before. This is one of the safest and not so painful treatments for keloids. However, one laser treatment session will not be enough to achieve the desired results and it is usually a costly treatment procedure which may not be affordable for all.

Cryotherapy: This treatment is very rare, where the keloids are frozen with liquid nitrogen to flatten them but most of the time it leads to darkening or lightening the site of treatment leaving it distinct with the surrounding skin.

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