[2010-04-01 12:17:56 - LMR from Philadelphia]: I once had a genital piercing that has left me with what I believe is either a keloid or a hypertonic scar, which I would like removed. What are my options and how much are the costs? Any information would be greatly appreciated!

[2010-04-10 17:54:47 - Dr. Ringpfeil]: Hypertrophic scars and keloids are very different in their biologic behavior. Both cannot be removed without trace but both can often be injected with a steroid and will reduce significantly or may resolve to a flat scar. There are circumstances under which scar revision by excision for a hypertrophic scar may be preferred, especially when the expected scar is minimal. However, the chance of another keloid developing, when an existing keloid is excised, is about 90%, and therefore excision is usually not an alternative. If several steroid injections soften a keloid without flattening it, shave excision may be attempted with additional steroid injections at time of excision, as well 2 and 4 weeks after to minimize the risk of a returning keloid. In very rare instances, when a keloid does not respond to steroid injections or is so large that it cannot be injected, radiation may be necessary. Cost of the procedure depends on the size of the lesion. We typically charge $50 per injection and anywhere between 1-3 may be needed for hypertrophic scars and between 2-10 treatments for keloids. Revision of hypertrophic scars by complete excision ranges between $150 (up to 5 mm) and $400 (over 4 mm). Shave removal of keloids may range between $130 (up to 5 mm) and $230 (over 2 cm). Three steroid injections needed after shave removal are charged in addition to the shave removal as mentioned above. Radiation is not a service that our office performs because it is rarely needed. While the revision of hypertrophic scars is not always an insurance covered service, most insurances cover the treatment of keloids.

[2012-05-25 07:53:06 - BJ from Bryn Mawr]: I have what you might call a medical emergency. A cluster of keloids(5) have grown to the size of 50cent peices on my face in my beard area. The skin is being expanded to the point breaks have occurred as well bleeding and a pus like substance drains out of the cracks. What procedure would best help my situation? I have insurance, but what would the cost of beneficial surgical correction be?

[2012-05-31 07:56:30 - Franziska Ringpfeil MD.]: What you describe does not only sound like keloids but a severe inflammatory reaction in the hair bearing area. The inflammation should be diagnosed, brought under control quickly to avoid further keloid formation and only when quiet should keloid treatment be considered.

[2012-03-26 15:17:54 - Z Gu from Villanova]: I have a friend in China who suffers from keloid and wants to come to the USA to get treatment. I am wondering if treatment of keloid is your specialty. If not, could you please recommend a specialist on keloid? Thanks for your help. Sincerely, Z. Gu

[2012-03-28 15:18:54 - Franziska Ringpfeil MD.]: Keloids are characterized by uninhibited scar formation. Medical and surgical (including laser) treatment is available and its efficacy and use depends on size and location of the keloid. While I have ample experience in the medical, surgical and laser treatment of keloids, I consider all dermatologists keloid specialists. Our office offers all aspects of keloid treatment.