How to treat keloids?

If a keloid, or scar tissue, has formed in or out of an existing scar, treatment is usually challenging. First and foremost, simple walking surgery will in most cases lead to a renewed and often even enlarged scar. However, this fact is not always considered even by surgeons with the good intention of quickly ridding their patients of the aesthetically disturbing problem.

Operation often unavoidable

With a keloid, it is best to consult an experienced dermatologist and discuss the appropriate treatment options there. In university hospitals there is often even a separate dermatological ambulance with a "scar consultation". Depending on the problem situation, it may be worthwhile to take a longer journey here.

With larger, coarse scar growths one comes to an operative removal of the excess tissue usually not around. During the operation, it is possible to apply Cortisone injections or cortisone inserts to the scar. These should prevent future growth.

Many specialists swear by so-called cryotherapy. At the same time, the scar region is quasi iced up at regular intervals with liquid nitrogen at -196 ° C. In the case of small keloids or just beginning keloid formation, even a single treatment with cryotherapy may be sufficient without previous surgery.

Radiotherapy only in particularly stubborn cases

For recurring and visually particularly disturbing keloids, one may also consider a special X-ray therapy. Here, only very superficially penetrating rays would be used, so it is assumed that the health burden of the residual tissue is very low. Nevertheless, radiologically sensitive areas of the body such as the female breast or the thyroid gland should not be treated with this method as a precaution. Radiation therapy for keloids would start immediately after surgical removal and be given over a week or so in regular, short sessions.

Since keloids are so difficult to treat, various therapy concepts have been tried and rejected in the course of time. The following keywords list treatment options that are used again and again, of which specialists in the treatment of scar growth but now rather discourage. These are:

  • interferon
  • methotrexate
  • verapamil
  • bleomycin
  • tacrolimus
  • retinoic acid
  • zinc
  • cyclosporine
  • imiquimod
  • laser therapy
  • Irradiation with ultraviolet light

Author: Dr. med. Monika Steiner