What is Keloid
Keloids are benign (noncancerous), fibrous skin tumours. They are most common in people with darker skin (e.g., people from West Africa or Southern India) and people usually develop them between the ages of 10 and 30. Both men and women are equally likely to have keloids.
What are the Causes
Keloids usually occur at the site of skin damage (e.g., acne, burns, chicken pox, cuts, insect bites, piercings, surgery, tattoos, vaccinations), although they can occur spontaneously. Whether or not a keloid will form is not determined by the severity of the wound – even a minor skin abrasion can result in keloid formation.
- Cryotherapy: Freezing keloids with liquid nitrogen may flatten them but often darkens or lightens the site of treatment.
- Interferon: Interferons are proteins produced by the body’s immune systems that help fight off viruses, bacteria, and other challenges. In recent studies, injections of interferon have shown promise in reducing the size of keloids, though it’s not yet certain whether that effect will be lasting. Current research is under way using a variant of this method, applying topical imiquimod (Aldara), which stimulates the body to produce interferon.
- Fluorouracil: Injections of this chemotherapy agent, alone or together with steroids, have been used as well for treatment of keloids.
Treatment & Procedure
- Cortisone injections (intralesional steroids): These are safe and not very painful. Injections are usually given once every four to eight weeks into the keloids) and usually help flatten keloids; however, steroid injections can also make the flattened keloid redder by stimulating the formation of more superficial blood vessels. (These can be treated using a laser; see below.) The keloid may look better after treatment than it looked to start with, but even the best results leave a mark that looks and feels quite different from the surrounding skin.
- Surgery: This is risky, because cutting a keloid can trigger the formation of a similar or even larger keloid. Some surgeons achieve success by injecting steroids or applying pressure dressings to the wound site for months after cutting away the keloid. Radiation after surgical excision has also been used.
- Laser: The pulsed-dye laser can be effective at flattening keloids and making them look less red. Treatment is safe and not very painful, but several treatment sessions may be needed. These may be costly, since such treatments are not generally covered by insurance plans.
- Silicone sheets: This involves wearing a sheet of silicone gel on the affected area continuously for months, which is hard to sustain. Results are variable. Some doctors claim similar success with compression dressings made from materials other than silicone.
- Radiation: Some doctors have reported safe and effective use of radiation to treat keloids.