Keloids - Patients ask Dr. Ringpfeil answers
Please feel free to use the blog below to share information about Keloids or to ask Dr. Franziska Ringpfeil a question that might be of interest to others.
A keloid is a type of scar that occurs spontaneously. Keloids may be hereditary and are commonly formed on areas such as the frontal midline of the body. People of Mediterranean or African descent are at higher risk of developing keloids. In our office, the treatment options for active keloids include intralesional Kenalog, intralesional Kenalog combined with 5-fluorouracil, pulsed dye laser (PDL) treatments, and CryoShape™.
Keloids may become itchy and tender, with the degree of pain varying from person to person. Intralesional steroid injections are recommended into firm keloids to treat symptoms and to reduce these keloids. Pulsed dye laser treatments help reduce acute inflammation and further soften the keloid. The CryoShape™ procedure utilizes a probe to freeze and destroy the scar tissue on the inside of a keloid with minimal discomfort and no pigment changes to the surrounding skin. This treatment is most appropriate for larger keloids that have been unresponsive to steroid injections.
Many physicians have performed surgical removal of keloids over the years; however, the likelihood for keloids to recur in surgically treated areas is extremely high and it is expected that any new keloid that forms is much bigger than the original one. If a keloid responds very well to corticosteroids but does not entirely flatten, surgery may be attempted if desired by the patient. Steroid injections must be performed at the time of surgery and every 2 weeks thereafter to prevent keloid formation at the site of surgical trauma. Usually, 3 injections after surgery are required to minimize the risk of keloid formation.
Keloids that do not respond to corticosteroids or are too big for meaningful injection may benefit from excision with subsequent radiation. If this is the case, we will refer you to a specialist that offers both treatments.