Keloids represent an excessive tissue response to dermal injury. They are diagnosed by a dermatologist. They rarely require pathohistological verification.
Types of keloid treatment
Keloid treatment must be multiple if we want to achieve a good result.
Keloid removal treatments are:
* Corticosteroid injection
* Surgical removal of lesions
* Laser treatment
* Cryotherapy
* Treatment with silicone gel sheets.
Corticosteroid injection
Injection of depot preparations of corticosteroids or local cytostatics in 50 to 80% of keloids leads to tissue reduction and keloid softening.
More than one treatment is needed, and the treatments are carried out at intervals of one month.
The therapeutic response is good, but after 5 years relapses can occur, i.e. new tissue overgrowth.
There are no criteria to serve as a reference for a doctor to predict keloid behaviour.
Surgical keloid removal
Surgical excision is used when keloid’s surface is large comparing to the region where they are located or when the outcome of previous treatments is aesthetically unsatisfactory.
After surgical removal of a keloid, it is necessary to treat the scar because the keloid will return completely.
In some cases, during the surgery, the wound itself is treated with corticosteroids.
Laser treatments should be started immediately after the removal of the surgical sutures.
Laser keloid treatment
Laser treatments enable reduced scar blood flow (Vbeam laser), as well as the transition of scar collagen into regular collagen. Keloids can be treated with Vbeam laser (pulsed dye laser), CO2 fractional laser, Q-switch laser.
Each of these lasers has a different skin and scar structure as the target, so it is sometimes necessary to combine all of the mentioned procedures.
The end result is collagen remodelling, stopping the keloid growth and eliminating the discomfort that keloids produce.
The combination of kenalog injection and lasers in one treatment is the most successful one.
Treatments are performed once a month. The number of treatments is individual, and the success rate is high.
Cryotherapy
Cryotherapy consists of tissue freezing with liquid nitrogen. The surface layer of keloids is removed without disturbing the deeper structures. It is combined with corticosteroids.
Silicone gel sheets
Silicone gel sheets are preventing the growth of keloids. In a certain percentage, they reduce tissue growth, but this therapy must be combined with another in order to obtain satisfactory results.
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