Origin and treatment of keloid scars
- A normal, thin scar
- An atrophic or wide and spread scar
- A hypertrophic or thick scar within the boundary of the initial incision
- A keloid scar
The keloid scar
Causes of keloids
Sebaceous glands and keloids
Treatment of keloids
The first thing I tell my patients with keloids is “you have a 50% chance that the treatment will work and a 50% chance that the keloid will come back and be even worse than before.” That is usually enough to scare away all but the most serious patients.
Keloid scar of the ear
Keloid scar treated by excision, injection and silicone cream
- Excision – cutting it out
- Pressure therapy – helps mold the collagen fibers
- Silicone gel therapy – flattens scar through unknown mechanism
- Injection with steroids – reduces scar’s inflammatory response and scar formation.
- Injection with 5-Flurouracil – reduces the rate of fibroblast cell division and hence scar formation
- Radiation therapy – kills the fibroblasts—and everything else around them
The patient shown here was treated via excision of the keloid, injection of steroids and 5-FU, as well as a silicone cream treatment. So far so good.