What Is It?

Keloids are defined as scars that greatly overgrow the original site of injury. They can occur after surgery as a result of trauma, from body and ear piercing, and in rare cases, can spontaneously occur. Keloids occur in all types of skin, but most frequently in black skin. The upper chest, back and the skin near joints are also danger zones. The chances of a keloid developing will be greatly reduced if you follow the directions given to you after surgical procedures, and minimize activities that cause movement in the surgical site.

Hypertrophic scares are often confused with keloids, but do not carry the risks of developing future unsightly scars that keloids do and are more easily treated. It is interesting to note that keloids that develop on the ears after piercing do not carry the same risks of future keloids that way keloids in other sites can.

Keloids can be unsightly and symptomatic, causing itch, pain and other problems. They can also interfere with movement of a limb.

Classical treatments have ranged from cortisone solutions injected into the scar at regular intervals to silicone gel sheeting and ointments, from primary excision all the way to radiation therapy. However, the lesions usually grow back and sometimes larger than before.

A new technique combining tangential (shave) excision of the keloid and injection of Intron-A (interferon A), an immune system modifying medicine, into the site has been shown to decrease the chances for regrowth from 75% to 25% (percentages given are average, your results can be better or worse). Intron-A is a medicine that is found in our own bodies. It helps our immune system fight off infection and caner. It is FDA-approved and is commonly used in the treatment of leukemia, hepatitis, and other immune-related illnesses. It is being used in an off-label manner for the treatment of keloids. The most common side effect is a flu-like syndrome (fever, chills, muscle aches, fatigue, headache, others) in the first 24 hours after injection. At the doses used for keloids, this syndrome is extremely unlikely to occur.

You will be given a prescription for the medicine to be filled before your procedure. The procedure is simple and straightforward. The area is numbed with local anesthesia. The keloid is removed even with the skin and the site is cleaned. The medicine is prepared and injected into the already numbed skin and a bandage is applied. That is all there is to it! A second appointment for post-procedure evaluation is set for 2 weeks to see how well the site has healed. At that time, dilute cortisone injections can be added to treat any residual raised areas. This procedure can be repeated as often as necessary and is usually covered by most insurance plans. It is important to remember that there are no guarantees for any medical therapy. Your keloids may return and require further, or other, treatments. Reasonable expectations are a must.

Other complimentary therapies may be required to obtain the greatest improvement. These can include pulse dye laser therapy, intralesional cortisone injections, and topical medicines such as Spectragel or Aldara cream.

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