Keloids & Scars

The treatment option will be discussed with your doctor and depend on the scar location, size and characteristics. It will also depend on your reasons for having treatment in the first place, i.e. is your scar causing you distress because of its appearance.

We offer three main treatments:

Steroid treatment: An injectable steroid, Triamcinolone is used. It is a quick treatment usually of a 5-15 minutes duration once the diagnosis and treatment options have been discussed. We use small amounts of steroid injections on repeated occasions to reduce or flatten mature scars (Scars which are older than 12months), usually 4-6 weeks apart.

Surgical scar revision: This technique is used to reposition or reduce the size of the scar. The techniques we use include:

Excision and direct skin closure is the surgical removal of the scar out and closure of the skin with stitches to create a more cosmetically appealing scar. Excision and realignment is the surgical removal of the scar and a change of direction in order to make the scar lie in the body’s natural relaxed skin tension line. On occasion those with transverse self harm scars on the arm will opt for a long longitudinal scar which has different social connotations.

Laser skin resurfacing: The Erbium YAG and CO2 laser are effective in dealing with scars. They use heat to remove the very top layer of your skin and stimulate the growth of healthy new skin. There is some downtime with lasering. With a surgical scar revision you may need to rest for a day or two.

Keloid is an overgrowth of the scar tissue that develops around a wound, mainly after the wound has healed. Often a hypertrophic scar is mistaken for a keloid. However, keloids grow beyond their original borders of the wound in contrast hypertrophic scars stay within the wound.

There is no real gold standard as the results are variable with many of the treatments and the recurrence rates are high. Steroid injections tend to be the first line in most medical practices. At EA Clinic Dr Anthony uses as combination of steroid concentrations during your treatment course.

1. Topical Steroid
2. Silicone creams gels/strips
3. Steroid injections
4. Laser; Pulsed Dye laser CO2 Laser or ND YAG
5. Cryotherapy
6. Injected anti-cancer drugs (ie. 5-FU and Bleomycin)
7. Surgery: Intralesional & extralesional excision. We prefer the intralesional approach to avoid damage and stimulation of healthy skin.
8. Radiotherapy

Avoid piercings, tattoos, unnecessary surgery and any injury to the skin.

Please apply high SPF sunblock (a minimum of SPF30 but ideally SPF50) to protect your skin from direct sun exposure over the treatment period and for a minimum of 6 weeks after the last treatment. Sun beds and sun bathing should be avoided.

The Signs and Symptoms of Keloid

Another excellent way to be able to differentiate a keloid from a regular scar is with the signs and symptoms. Keloids are often raised, dome-shaped and have a shiny appearance. They range in colors from dark brown, pink, purple and red, and can be large and unsightly. You may also experience itchiness, tenderness or even pain.

There are also some common areas of the body that keloids are more likely to appear on, such as:

• Chest
• Back
• Earlobes
• Shoulders
• Face

The best way to prevent keloids is always prevention. If you have a family history of keloids it is always better to avoid any trauma to the skin no matter how minor, or even body piercings and tattoos as these can encourage keloid growth. When the skin has been injured the use of gentle emollient creams and silicon gels have been documented to help.