Materiały źródłowe

• #1 Management of keloid scars: noninvasive and invasive treatments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8007468/

  Scars vary from mature linear scars to abnormal excessive scars such as hypertrophic scars and keloid scars. Keloid scars are fibro-proliferative disease entities that reflect an abnormal process of wound healing. They can cause pain, itching, stiffness, and psychological distress, all of which can affect quality of life. Various treatment options have been advocated as ways to prevent and treat keloid scars. These include noninvasive treatments such as use of silicone gel sheeting and compression therapy, and invasive treatments such as intralesional corticosteroid injections, surgery, and radiotherapy. Novel treatments include chemotherapy, immunotherapy, and anti-inflammatory therapies. Unfortunately, keloids continue to pose a significant challenge due to the lack of efficacious treatments. Therefore, clinicians should be familiar with various therapeutic options and apply the most suitable treatment plan for patients. In this review, we introduce the current therapeutic options for the management of keloid scars.

• #1 Hypertrophic Scars and Keloids: A Complete Overview — DermNet

  https://dermnetnz.org/topics/keloid-and-hypertrophic-scar

  A hypertrophic scar may resolve spontaneously and is likely to respond better to treatment than a keloid. Conversely, keloids are likely to persist without spontaneous resolution and prove resistant to treatment. […] The aims of treatment are to reduce the cosmetic disfigurement and functional problems caused by the keloid and reduce pain and itch. […] The following measures are helpful in at least some patients: Emollient creams and oils massaged regularly into the scar, Polyurethane or silicone scar reduction patches, Silicone gel, Oral or topical tranilast (an inhibitor of collagen synthesis), Pressure dressings and garments, Surgical excision (in keloids, surgical excision may result in a new keloid even larger than the original one), Intralesional corticosteroid injection, repeated every few weeks, Intralesional 5-fluorouracil, Cryotherapy, Superficial X-ray treatment (delivered within 48 hrs after surgical excision), Pulsed dye laser, Skin needling, Steroid impregnated tape, Subcision, Retinoic acid, Botulinum toxin injections. […] Scar dressings should be worn for 12-24 hours per day, for at least 8 to 12 weeks, and perhaps for much longer.

• #1 Keloid Scar: What It Is, Symptoms, Treatment & Removal

  https://my.clevelandclinic.org/health/diseases/keloid-scar

  A less common form of treatment is radiation therapy. […] Your healthcare provider will discuss the side effects of treatment with you before you begin. […] Keloids may reduce or shrink after corticosteroid injections. […] If your provider recommends pressure garments, you’ll likely need to wear those for up to 20 hours per day, possibly for weeks or months. […] While you can’t always prevent keloids, treatment options are available to ease discomfort and reduce the appearance of these scars on your skin.

• #1 Keloid scar – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/keloid-scar/diagnosis-treatment/drc-20520902

  Keloid scar treatments include the following. One or a combination of approaches might be best for your situation. Even after successful flattening or removal, keloids can grow back, sometimes bigger than before. Or you may develop new ones. […] For newer keloids, the first treatment option might be compression dressings made from stretchy fabric or other materials. This method is also used after surgery to remove keloids. The goal is to reduce or prevent a scar by putting pressure on the wound as it heals. Such dressings need to be worn for 12 to 24 hours a day for 4 to 6 months to be effective. This method can be very uncomfortable. […] Applying a prescription strength corticosteroid cream can help ease itchiness. […] If you have a smaller keloid, your doctor might try reducing its thickness by injecting it with cortisone or other steroids. You’ll likely need monthly injections for up to six months before seeing the scar flatten. Possible side effects of corticosteroid injections are skin thinning, spider veins and a permanent change in skin color (hypopigmentation or hyperpigmentation).

• #1 Keloids: A Review of Etiology, Prevention, and Treatment | JCAD – The Journal of Clinical and Aesthetic Dermatology

  https://jcadonline.com/keloids-scars-treatment-review/

  Used successfully for the treatment of basal cell carcinoma and human papillomavirus-related warts, imiquimod 5% cream has shown promise as an adjuvant therapy for keloids after excision. […] Mitomycin C can reduce keloid recurrence postexcision. […] When used as a monotherapy for keloids, 5-FU has been reported to have a 21 to 35 percent rate of recurrence at a minimum of three months and maintain keloid volume reduction of keloids for at least six months after the last therapy session in 58 to 65 percent of patients. […] Interferon alpha-2b and interferon gamma have been evaluated as therapeutic treatment options for keloids. […] Bleomycin has been shown to suppress collagen synthesis by dermal fibroblasts, increase collagen turnover, and decrease the levels of lysyl-oxidase required for collagen maturation.

• #1 Keloid and Hypertrophic Scar Treatment & Management: Medical Care, Prevention, Standard Treatments

  https://emedicine.medscape.com/article/1057599-treatment

  No single therapeutic modality is best for all keloids. The location, size, and depth of the lesion; the age of the patient; and the past response to treatment determine the type of therapy used. […] Prevention is key, but therapeutic treatment of an existing hypertrophic scar or keloid includes occlusive dressings, compression therapy, intralesional corticosteroid injections, cryosurgery, excision, radiation therapy, laser therapy, interferon (IFN) therapy, 5-fluorouracil (5-FU), doxorubicin, bleomycin, verapamil, retinoic acid, imiquimod 5% cream, tamoxifen, tacrolimus, botulinum toxin, hydrogel scaffold, and over-the-counter treatments (eg, onion extract; combination of hydrocortisone, silicon, and vitamin E). These therapies have been used to reduce the rate of keloid recurrence after surgical excision, with superficial radiation therapy being the most effective.

• #1 CG-SURG-31 Treatment of Keloids and Scar Revision

  https://www.anthem.com/dam/medpolicies/abc/active/guidelines/gl_pw_c147702.html

  Treatment of a keloid with radiation therapy (up to 3 fractions) is considered medically necessary as adjunct therapy following surgical excision (initiated within 3 days) when the reconstructive criteria for keloid removal are met. […] Treatment of keloids is considered cosmetic and not medically necessary when performed in the absence of a significant functional impairment, is not reconstructive, and is intended to change a physical appearance that would be considered within normal human anatomic variation. […] Generally accepted prophylactic and therapeutic treatments that may be effective and performed as monotherapy or in combination with other therapeutic regimens for keloids or hypertrophic scar tissue that cause significant pain or result in a significant functional impairment include, but are not limited to, intralesional corticosteroid injections (with or without 5-fluorouracil), ablative and non-ablative laser therapy and laser resurfacing with carbon dioxide (CO2), potassium-titanyl-phosphate (KTP), pulsed-dye, or Yttrium-Aluminum Garnet (YAG) lasers, radiation therapy, and surgical excision or revision procedures (for example, W-plasty, Z-plasty, or small-wave incisions, with or without skin flap/grafting).

• #1 Keloid Scar Treatments: Do They Work?

  https://www.webmd.com/skin-problems-and-treatments/what-are-treatments-for-keloid-scars

  Steroid-impregnated tape, applied on your keloid for 12 hours a day […] Pressure earrings, which are a special type of earring that helps to reduce the keloid scars in your earlobes […] Interferon injections to help reduce the size of keloid scars. Interferon is a protein produced by the body to help fight viruses. […] Fluorouracil and bleomycin injections, which are anti-cancer agents that can be used to treat keloid scars.

• #1 Keloid Scars: Symptoms, Causes, and Treatments

  https://www.healthline.com/health/keloids

  Keloid scarring can form on large areas of your body, but this is generally rare. When it happens, the hardened, tight scar tissue may restrict your movement. […] The decision to treat a keloid can be a tricky one. Keloid scarring is the result of your body’s attempt to repair itself. After the keloid is removed, the scar tissue may grow back, sometimes larger than before. […] Initially, your doctor will probably recommend less-invasive treatments, such as silicone pads, pressure dressings, or injections, especially if the keloid scar is fairly new. […] Corticosteroids combined with botulinum toxin type A injections into the keloid tissue have been found to be effective in shrinking keloids. […] In the case of very large keloids or an older keloid scar, surgical removal may be recommended. The rate of return for keloid scarring after surgery can be high. However, the benefits of removing a large keloid may outweigh the risk of postsurgery scarring.

• #1 Keloid scar – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/keloid-scar/diagnosis-treatment/drc-20520902

  Small keloids might be reduced or removed by freezing them with liquid nitrogen (cryotherapy). Repeat treatments might be needed. Possible side effects of cryotherapy are blistering, pain and loss of skin color (hypopigmentation). […] Larger keloids can be flattened by pulsed-dye laser sessions. This method has also been useful in easing itchiness and causing keloids to fade. Pulsed-dye laser therapy is delivered over several sessions with 4 to 8 weeks between sessions. Your doctor might recommend combining laser therapy with cortisone injections. Possible side effects, which are more common in people with darker skin, include hypopigmentation or hyperpigmentation, blistering and crusting. […] Low-level X-ray radiation alone or after surgical removal of a keloid can help shrink or minimize the scar tissue. Repeat treatments might be needed. Possible side effects of radiation therapy are skin complications and, in the long term, cancer.

• #1 Keloid Hypertrophic Scar Repair San Ramon | Keloid Treatment

  https://www.drwilliamting.com/procedures/medical-dermatology/keloid-hypertrophic-scar/

  The advantages of the Cryoshape modality include the ability to treat multiple keloid scars in one outpatient session with no surgical excision required. […] Intralesional steroid injection is the traditional, most widely performed method of keloid scar removal. […] While intralesional steroid injection is typically covered by most insurance carriers (subject to typical copay, deductible and coinsurance), the use of adjunctive intralesional 5-fluorouracil is considered elective. […] Often in combination with medical treatment, supplementary techniques can help to enhance the results of your procedure. […] This procedure is highly suitable for patients seeking to treat hypertrophic scars or to further smooth out skin texture and skin tone of already flattened scar tissues after utilizing above mentioned modalities. […] By reducing reddish skin tone of the keloid tissues with combination of the advanced vascular lasers at California Dermatology Care, Dr. Ting and the clinical team can help you minimize unwanted visual attention drawn to the keloid or hypertrophic scar tissues.

• #1 The dermatologist’s guide to treating keloids: 5 pearls and promising future therapies – The Dermatology Digest

  https://thedermdigest.com/the-dermatologists-guide-to-treating-keloids-5-pearls-and-promising-future-therapies/

  The larger gauge makes it easier for medication to enter the keloid and helps improve comprehensive keloid treatment. […] There is a lot of pressure within the keloid. When you inject the anti-keloid medication, the medication can spray back onto the injector, Dr. Jagdeo said. […] Dermatologists should let keloid patients know they likely will need multiple treatmentsusually at least 4 to 6 to improve the keloid dramatically. Treatment can take a while. And keloids can return. […] Depending on the setting, CO2 laser therapy can safely decrease inflammation and pigmentary change post-laser and decrease keloid size, according to Dr. Jagdeo. […] Best results are achieved over a series of treatments spaced at least 1 month apart per treatment, he said. […] An emerging keloid treatment that excites Dr. Jagdeo is the use of light-emitting diode (LED) red light technology.

• #1 Keloids: A Review of Etiology, Prevention, and Treatment | JCAD – The Journal of Clinical and Aesthetic Dermatology

  https://jcadonline.com/keloids-scars-treatment-review/

  Beyond simple surgical excision, surgical management of keloids encompasses multiple novel reconstructive techniques that have demonstrated reduced rates of recurrence with treatment-resistant keloids. […] Cryotherapy involves the administration of freezing therapy to keloids to reduce scar volume and recurrence. […] Radiation therapy has been shown to be most effective as an adjunctive therapy to surgical excision compared to monotherapy. […] PDL is a form of nonablative laser therapy that targets keloid microvasculature to improve scar appearance. […] There is evidence that multiple ablative CO2 treatments are necessary for longer-lasting scar improvement. […] Laser-assisted drug delivery (LADD) has been shown to increase drug penetration and decrease the required dosage for optimal efficacy in murine and porcine skin models.

• #1 Laser Therapy for Scars and Keloids

  https://www.dermatologytimes.com/view/laser-therapy-for-scars-and-keloids

  Jill Waibel, MD, discusses her recommendations on how to treat keloids and scaring using lasers in her presentation at the Skin of Color Update 2021. […] Waibel is medical director and owner, Miami Dermatology and Laser Institute, subsection chief of dermatology, Baptist Hospital, medical director, Multidisciplinary Skin Cancer Clinic, Miami Cancer Institute, all in Miami Florida and Dermatology Times editorial board member. […] Although it is usually used for wrinkles, ablative fraction laser (AFL), according to Waibel, was the laser that changed the treatment world for scars. […] The one thing that I almost always do with every scar patient I treat and every keloid patient I treat is laser assisted drug delivery, Waibel said. […] For keloids, as the knowledge is still growing on how to treat them, Waibel explained that she never tells a patient it wont come back after treatment.

• #1 Keloid scar – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/keloid-scar/diagnosis-treatment/drc-20520902

  If your keloid hasn’t responded to other therapies, your doctor might recommend removing it with surgery in combination with other methods. Surgery alone has a recurrence rate of 45% to 100%. […] There are no proven methods of removing keloid scars naturally. Some clinical studies have shown that onion extract used orally or on the skin might possibly be effective in improving the appearance of keloid scars and reducing itchiness and discomfort. […] Research into wound-healing issues, including keloid formation, shows promise. For example, studies include: Experimental topical creams and injectables to reduce and stop the growth of keloids, Botulinum toxin type A (Botox) to improve wound healing, Identifying genetic markers in keloid tissue, Stem cell therapy.

• #1 Keloid scars: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/keloids-treatment

  Many people who have keloids want to know about treatment. […] A treatment plan for keloids may include: […] Injections of corticosteroids or another medication: These injections are often part a treatment plan for keloids. When injected into the keloid, these medicines help to shrink the scar. […] Between 50% and 80% of keloids shrink after being injected. Many of these keloids, however, will regrow within five years. […] Keloid surgery: Your dermatologist can surgically cut out the keloid. While this may seem like a permanent solution, its important to know that nearly 100% of keloids return after this treatment. […] To help reduce the risk of a keloid returning after surgery, some patients receive a series of corticosteroid injections before surgery. […] Pressure earring, dressing, or garment: Often used after keloid surgery to reduce blood flow. This may stop a keloid from returning.

• #1 Keloid Scar Treatment In Houston | Premier Plastic Surgery

  https://pearlandpps.com/skin-rejuvenation/keloid-scar-treatment/

  Suppose the scar has been determined to be amenable to surgical excision or keloid surgery. In that case, Premier Plastic Surgery has an established protocol that uses lasers and injections as necessary to help prevent the recurrence of the scar once it has been excised. […] During your initial consultation, we will take your detailed medical history, and Dr. Hankins will examine your keloid scar and determine the right treatment plan for you. You and Dr. Hankins will be able to determine whether one or a combination of keloid scar treatments is best for you. […] At Premier Plastic Surgery, our recommended treatment is generally surgical. We enhance the procedure by injecting triamcinolone into the wound at the time of surgery. In selected cases, superficial radiation therapy or SRT can be given within 24 hours after surgery.

• #1 Keloid Scar Treatments: Do They Work?

  https://www.webmd.com/skin-problems-and-treatments/what-are-treatments-for-keloid-scars

  Smaller keloids can sometimes be frozen off using liquid nitrogen. This treatment, called cryotherapy, can cause side effects including blisters, pain, and a loss of color in the affected skin (hypopigmentation). […] If nothing else works, your doctor may recommend surgery to remove your keloid scar. However, up to 100% of keloid scars come back after surgery. Your doctor will likely recommend another treatment to go along with the surgery, such as steroid injections, to reduce the risk of further scarring. […] Following your doctor’s instructions after surgery will reduce the risk of the scar returning. Your doctor may tell you to wear a pressure garment for up to 20 hours per day for at least a few months to reduce the risk of a new scar forming. […] Other treatments for keloid scars include:

• #1 Management of Keloids and Hypertrophic Scars | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0801/p253.html

  If neither silicone nor corticosteroids are effective over 12 months, second-line surgical treatment followed by corticosteroids and possibly silicone sheeting should be considered. The use of corticosteroid injections following keloid surgery reduces the recurrence rate to less than 50 percent. […] A triple keloid therapy combining surgery, corticosteroids, and silicone sheeting has been shown to be even more effective, with only a 12.5 percent recurrence rate after 13 months. […] Imiquimod 5% cream (Aldara), an immune response modifier that enhances healing, has also been used to help prevent keloid recurrence after surgical excision. […] Treatment of keloids with short-pulsed, 585-nm pulsed dye laser has shown limited promise, with a 57 to 83 percent improvement rate. […] Other therapies with limited studies include intralesional verapamil, fluorouracil, bleomycin, and interferon alfa-2b injections. Although all of these have results comparable or sometimes superior to corticosteroid injection and silicone sheeting, the optimal keloid therapy remains undefined.

• #1 Keloid – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507899/

  Radiotherapy – Best utilized as adjuvant therapy 24 to 28 hours following excision. Caution should be used in patients less than 18 years of age and in vulnerable areas such as the head, neck, and breast as it carries an inherent risk of carcinogenesis. […] Laser – Successive sessions using 585 nanometers (nn) pulse-dye laser and 1065 nm neodymium-doped yttrium aluminum garnet (ndYAG) laser have been shown to induce flattening and regression of keloids. […] Other treatments including topical imiquimod following excision, intralesional botox, intralesional bleomycin, intralesional 5-fluorouracil, and silicone gel sheeting have also been reported to be successful in treating keloid scars either alone or in combination with the above modalities. […] It is important to manage patient expectations as all treatments require multiple sessions and do not uniformly result in complete regression of keloid. The most successful treatment results from the use of multiple modalities and tailoring therapy to meet patient needs.

• #1 The dermatologist’s guide to treating keloids: 5 pearls and promising future therapies – The Dermatology Digest

  https://thedermdigest.com/the-dermatologists-guide-to-treating-keloids-5-pearls-and-promising-future-therapies/

  Dr. Jagdeo has authored research showing LED red light treatment helps decrease molecular and other factors associated with keloid scarring, decreases collagen, and can melt away keloids. […] It is phenomenally impressive, he said Some of the things that are nice about it is that it is noninvasive, there is no downtime and no recovery time, it is relatively inexpensive and easy to administer, and is combinable with other treatment options. […] If we can selectively increase or modulate microRNA into a favorable milieu, then we might benefit and improve keloids. This is on the horizon, he said. […] There is a lot of opportunity to use botulinum toxin therapy to treat scars. It relaxes some of the tension on the scar and helps decrease some of the factors associated with skin scarring.

• #1 Can You Get Rid of Keloids? Treatments and Home Remedies

  https://www.healthline.com/health/how-to-get-rid-of-keloids

  A 2020 review and a 2015 study suggest that aspirin may help treat keloids. Research found that aspirin prevents scar-promoting cells from entering the keloid site. As a result, both pigmentation and keloid size are reduced. Aspirin can be applied topically at home. […] Honey contains anti-inflammatory compounds that may help reduce keloids. Honey was mentioned in a 2020 study for its healing potential with keloids specifically. Its an appealing natural alternative without the potential side effects associated with corticosteroids or nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin. […] If keloids dont improve with the help of home remedies, talk with a doctor about other treatments. They may recommend OTC or prescribed creams and gels. […] Surgical and laser removal are also successful treatment options if other methods dont work. Keep in mind that whatever method is used to treat keloids, once they occur, they have a very high chance of returning.

• #1 Keloid treatments: an evidence-based systematic review of recent advances | Systematic Reviews | Full Text

  https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-023-02192-7

  For established keloids, intralesional corticosteroids are the first-line treatment with or without additional therapeutics topically or intralesionally, as is recommended by many consensus guidelines. […] Other intralesional injections including botulinum toxin A (BTA), bleomycin, mitomycin C, PRP, and collagenase have been recently investigated. […] Excision followed by radiation therapy has been shown to consistently reduce the risk of recurrence. […] Recent investigations of novel treatments have had some promising results. Application of a hydrogel scaffold after excision had low recurrence rates, though have not yet been compared in randomized comparative trials.

• #1 Management of keloid scars: noninvasive and invasive treatments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8007468/

  Radiation therapy is most effective as an adjunct to surgery. The combination of radiation therapy and surgery was found to be the most effective treatment in severe keloid cases and reduced recurrence by 55% at 30 months of follow-up. […] For keloids, the primary treatment recommended was silicone gel sheeting with compression therapy and moisturizing. If keloids continue to grow, silicone gel sheeting and pressure therapy, as well as intralesional injections of corticosteroids (5-fluorouracil, bleomycin or verapamil can also be considered) are recommended in combination. If there is no response, surgical excision (along with a skin graft or flap) may be considered, combined with iridium, other localized radiotherapy, or intralesional cryotherapy.

• #1 Keloids – British Skin Foundation

  https://knowyourskin.britishskinfoundation.org.uk/condition/keloids/

  Surgically removing/excising (cutting out) a keloid is rarely a success as this can cause a larger wound and the keloids is likely to regrow in it. If it is excised, the risk of regrowth may be reduced by compression dressings or steroid injections following the procedure. […] Unfortunately, there is no cure for keloids. Treatment can sometimes help to flatten them and reduce irritation. There is currently no evidence that any single form of treatment is better than another and keloids often regrow in the same place. Treatment options include: […] Injection of a steroid into the keloid i.e. intralesional injection. This is the most common treatment. Injections can be repeated e.g. monthly for 4-6 months. Steroids can make the skin thin, fragile and pale. Up to 50% of keloids grow back.

• #1 Keloid – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507899/

  Keloids remain a therapeutic dilemma. Not only are they difficult to treat but incomplete therapy can lead to a keloid worsening and growing. Therefore, primary prevention is key. Predisposed individuals should avoid elective procedures if possible, especially ear piercing and tattooing. If accidental trauma occurs or surgical interventions are required, there are ways to minimize and perhaps prevent the development of keloid scar. Minimizing wound tension is important to reduce the risk for keloid development. Rapid primary closure and adequate hemostasis are the cited key elements in tension-free wound closure. Prolonged wound stabilization using silicone sheeting also may help reduce tension on wounds. Compression therapy is noted in the literature to reduce keloid development with pressures of 15 to 45 mmHg recommended for more than 23 hours per day for at least 6 months.

• #1 Keloid scars: Self-care

  https://www.aad.org/public/diseases/a-z/keloids-self-care

  If you’re concerned that a cosmetic procedure may cause a keloid, tell your dermatologist or other doctor who will perform the procedure. […] A dermatologist can fit you with a pressure garment. Adding another keloid treatment like injections of corticosteroids may also help. […] Your surgeon may be able to take precautions that can reduce your risk of developing a keloid. Having keloid treatment after surgery can also help. […] If you notice it thickening, contact a dermatologist right away. A dermatologist may be able to prevent the thickening skin from becoming a keloid. […] Proper wound care may help prevent a keloid. […] After the wound scabs, apply silicone gel sheets or silicone gel. […] They can help prevent a keloid. […] To get the best results, you apply a new sheet or gel to the area every day. […] If you’re unsure when to stop, see a board-certified dermatologist. […] If you have brown or black skin, dermatologists recommend using a tinted sunscreen. […] If you are concerned about thickening skin or an existing scar, a dermatologist can create a treatment plan tailored to your needs.

• #1 Management of keloid scars: noninvasive and invasive treatments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8007468/

  Various treatment options have been proposed as ways to prevent and treat keloid scars. Although differences might exist in the pathogenesis of keloid scars across ethnicities, the international advisory panel, Chinese expert consensus, and Japan scar workshop consensus have presented similar treatment options. These include noninvasive treatments such as silicone gel sheeting, physiotherapy, and compression therapy, as well as invasive treatments such as intralesional corticosteroid injections, radiotherapy, cryotherapy, and surgery. […] Despite the introduction of numerous available treatment options, keloid scars remain a therapeutic challenge. Therefore, clinicians should be familiar with the therapeutic options and to be able to provide the most suitable treatment. Here, we introduce the currently available therapeutic options and strategies, both noninvasive and invasive, for the management of keloid scars, as well as novel therapies under investigation.

• #1 Keloid scar | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/keloid-scar

  Keloid scar treatment is possible. If you don’t like how a keloid looks or feels, talk with a doctor about how to flatten or remove it. Even with treatment, a keloid can last for years or recur. […] Keloid scar treatments include the following. One or a combination of approaches might be best for your situation. Even after successful flattening or removal, keloids can grow back, sometimes bigger than before. Or you may develop new ones. […] Wound care. For newer keloids, the first treatment option might be compression dressings made from stretchy fabric or other materials. This method is also used after surgery to remove keloids. The goal is to reduce or prevent a scar by putting pressure on the wound as it heals. Such dressings need to be worn for 12 to 24 hours a day for 4 to 6 months to be effective. This method can be very uncomfortable.

• #2 Management of Keloids and Hypertrophic Scars | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0801/p253.html

  A more recent article on management of keloids and hypertrophic scars is available. […] Keloid formation often can be prevented if anticipated with immediate silicone elastomer sheeting, taping to reduce skin tension, or corticosteroid injections. Once established, however, keloids are difficult to treat, with a high recurrence rate regardless of therapy. Evidence supports silicone sheeting, pressure dressings, and corticosteroid injections as first-line treatments. […] Surgical removal of keloids poses a high recurrence risk unless combined with one or several of these standard therapies. Alternative postsurgical options for refractory scars include pulsed dye laser, radiation, and possibly imiquimod cream. […] Intralesional verapamil, fluorouracil, bleomycin, and interferon alfa-2b injections appear to be beneficial for treatment of established keloids.

• #2 Keloid scars

  https://www.nhs.uk/conditions/keloid-scars/

  A keloid scar is a raised scar left on the skin after a wound has healed. You cannot get rid of it, but treatment can help improve how it looks. […] The GP can recommend treatments to improve how it looks. Getting treatment early may help stop the keloid scar growing. […] You cannot get rid of a keloid scar, but there are treatments that can help improve how it looks and reduce irritation. […] Treatments may include: steroid injections or cream, silicone dressings or gels, cryotherapy (a treatment to freeze the keloid scar), laser therapy. […] Surgery to remove the keloid scar is not usually recommended because it’s likely to grow back bigger.

• #2 Keloid scars: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/keloids-treatment

  Many people who have keloids want to know about treatment. […] A treatment plan for keloids may include: […] Injections of corticosteroids or another medication: These injections are often part a treatment plan for keloids. When injected into the keloid, these medicines help to shrink the scar. […] Between 50% and 80% of keloids shrink after being injected. Many of these keloids, however, will regrow within five years. […] Keloid surgery: Your dermatologist can surgically cut out the keloid. While this may seem like a permanent solution, its important to know that nearly 100% of keloids return after this treatment. […] To help reduce the risk of a keloid returning after surgery, some patients receive a series of corticosteroid injections before surgery. […] Pressure earring, dressing, or garment: Often used after keloid surgery to reduce blood flow. This may stop a keloid from returning.

• #2 Management of keloid scars: noninvasive and invasive treatments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8007468/

  Current international guidelines recommend intralesional corticosteroid injections as the first-line therapy for the prevention and treatment of keloids. They can be used alone or in conjunction with other treatments. […] Triamcinolone acetonide is used clinically at concentrations between 10 and 40 mg/mL, with 2 to 3 injections per month administered for 6 months or even longer, depending on the location, size, and volume of the keloid, as well as the individual patients characteristics. […] Surgical excision of keloids is a popular option and is recommended as the first-line treatment if disabling scar contracture is present. However, it should be used with caution since it often creates even larger lesions, and recurrence rates are high (45%100%). Adjuvant measures, such as radiotherapy, interferon, bleomycin, cryotherapy, or corticosteroids, should be applied to avoid recurrence.

• #2 Keloids – British Skin Foundation

  https://knowyourskin.britishskinfoundation.org.uk/condition/keloids/

  Applying a strong steroid cream or steroid-containing tape. These require a prescription. […] Silicone dressings or gels are safe and can be bought from a pharmacist without prescription. If used for several months, they can reduce the thickness and make the keloid paler. […] Compression with bandages or devices (such as clips or splints) may sometimes help, particularly on the earlobe and for keloids on the torso. […] Radiotherapy can be given after surgical removal of keloid scars. However, it carries a small risk of causing skin cancer as a result of exposure to radiation, so is rarely used. […] Cryotherapy can be tried alone or in combination with other treatment methods. It can cause loss of skin pigment. […] Laser therapy can help, especially if combined with injected steroids. […] Experimental treatments include botulinum toxin injections; injections of the anti-cancer drugs 5-fluorouracil (5-FU) or bleomycin; and photodynamic therapy. These options are not routinely available and further research in these areas is required.

• #2 Non-Surgical Treatments for Hypertrophic and Keloid Scars | CCID

  https://www.dovepress.com/a-comprehensive-review-of-non-surgical-treatments-for-hypertrophic-and-peer-reviewed-fulltext-article-CCID

  The antineoplastic agent 5-fluorouracil (5-FU) is an approved therapy for colorectal and breast cancers; however, off-label use of this drug includes the treatment of HTS and keloids. Many studies have demonstrated the efficacy of 5-FU in the treatment of keloids and HTS; however, few have sought to investigate the monotherapeutic option specifically in FSTs IVVI. In 2002, Gupta and Kalra demonstrated the successful treatment of keloids in 24 patients (FSTs IV and V) with 50-150 mg intralesional injections of 5-FU, once weekly, for up to 16 weeks or until therapeutic satisfaction. 33.3% of patients demonstrated 75% flattening and about half of participants showed 50% flattening. 70.8% of patients reported decreases in symptoms of pruritus, pain, and discharge, with no recurrence at 36 month follow-ups. Importantly, hyperpigmentation was observed in all patients and ulceration in one patient, but all adverse events were found to resolve upon therapeutic cessation.

• #2 Non-Surgical Treatments for Hypertrophic and Keloid Scars | CCID

  https://www.dovepress.com/a-comprehensive-review-of-non-surgical-treatments-for-hypertrophic-and-peer-reviewed-fulltext-article-CCID

  Several antineoplastic agents have been investigated for their role in treating HTS and keloids. Two commonly used compounds are bleomycin and 5-fluorouracil (5-FU). These drugs are classified as antimitotic because they inhibit cell proliferation and promote apoptosis. Bleomycin has more recently been repurposed in order to address hyper-fibrotic skin conditions. Bodokh and Brun published a study in 1996 where they noted marked volume reduction and decreased functional impairment in several of 31 keloids and 5 HTS following intralesional bleomycin injection. Further studies have confirmed that bleomycin inhibits proteins in the aforementioned TGF- pathway. The efficacy of bleomycin for HTS and keloids in skin of color appears relatively well-established in comparison to other treatment methods. One study by Huu et al found that intralesional bleomycin injections were effective in reducing keloid scar volume (70.8% complete flattening) within the Vietnamese population. Even in cases where incomplete flattening was noted, Vancouver Scar Scale (VSS) data demonstrated an 80.8% and 70.3% reduction in pruritus and pain, respectively. Notably, however, pain, hyperpigmentation (56.7%), blistering, and scar recurrence (50% after 18 months) were reported adverse effects.

• #2

  https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=abp9862

  There is no sure cure for keloids, but treatment sometimes improves how they look and feel. It is common for keloids to grow back after treatment. […] When trying to treat a keloid, your doctor may need to use more than one type of treatment. Based on a keloid’s size and location, and how soon it is treated, your doctor may: […] Freeze it. This is called cryotherapy. It is best used for small keloids, such as from acne. Cryotherapy can lighten the skin. […] Inject it with medicine. A corticosteroid is the most commonly used medicine for reducing keloids. It is most likely to work well with cryotherapy or right after surgery. […] Other medicines may improve keloids. These include verapamil, fluorouracil, bleomycin, and interferon alfa-2b shots. They are not as well studied as corticosteroid shots, but your doctor may recommend trying one. They are most likely to work when used with another treatment.

• #2 The dermatologist’s guide to treating keloids: 5 pearls and promising future therapies – The Dermatology Digest

  https://thedermdigest.com/the-dermatologists-guide-to-treating-keloids-5-pearls-and-promising-future-therapies/

  Studies suggest botulinum toxin A might reduce skin fibrosis by decreasing fibroblast proliferation, modulating the activity of transforming growth factor-, and reducing transcription and expression of profibrotic cytokines in keloid-derived and hypertrophic scar-derived dermal fibroblasts. […] Experts should be in control of keloid management. Skills needed include surgical removal, injection techniques, laser adjuvant treatments, and expecting the unexpected, said Dr. Jagdeo.

• #2 Keloid scars: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/keloids-treatment

  Silicone gel sheets: Made from medical-grade silicone, these sheets may help to flatten a keloid. […] Freezing (cryosurgery): If you have darkly pigmented skin, this may not be recommended. […] Cryosurgery is also recommended before (or after) receiving injections of corticosteroids. […] Laser treatment: This can reduce the height and fade the color of a keloid. […] Radiation treatments: For more than 100 years, radiation has been used to help prevent a keloid from growing back after youve had another treatment like surgery. […] Ligature: If a surgical thread can be tied around the keloid, your dermatologist may recommend this treatment. […] No treatment can consistently get rid of a keloid. […] For these reasons, dermatologists are working to better understand what causes keloids and develop more effective treatment. […] How you care for your skin can make a difference. Be sure to follow the at-home care that your dermatologist gives you.

• #2 Keloids Cryotherapy: Benefits of the Procedure | Miami, FL

  https://www.thekeloidplasticsurgerycenter.com/blog/cryotherapy-keloid-benefits/

  Intralesional cryotherapy is an effective treatment for larger keloids and hypertrophic scars, as it can help to reduce the size of the scar tissue while also helping to prevent further scarring. […] Keloid recurrence rates following successful cryotherapy treatment hover around 5% which is significantly less than what is seen with other forms of Keloid management strategies where up to 50% could see their keloid recurring. […] Combination therapy is a popular approach to treating keloids, as it combines cryotherapy with other treatments such as corticosteroid injections or laser therapy. […] Cryotherapy is an effective treatment for reducing the size and volume of surgical scars, while also helping to minimize itching and inflammation associated with them. […] Cryotherapy prevents scar formation due to its accelerated healing time, which helps prevent excessive collagen accumulation that would otherwise occur if left untreated or treated with other methods over a longer period.

• #2 Laser Therapy for Scars and Keloids

  https://www.dermatologytimes.com/view/laser-therapy-for-scars-and-keloids

  Jill Waibel, MD, discusses her recommendations on how to treat keloids and scaring using lasers in her presentation at the Skin of Color Update 2021. […] Waibel is medical director and owner, Miami Dermatology and Laser Institute, subsection chief of dermatology, Baptist Hospital, medical director, Multidisciplinary Skin Cancer Clinic, Miami Cancer Institute, all in Miami Florida and Dermatology Times editorial board member. […] Although it is usually used for wrinkles, ablative fraction laser (AFL), according to Waibel, was the laser that changed the treatment world for scars. […] The one thing that I almost always do with every scar patient I treat and every keloid patient I treat is laser assisted drug delivery, Waibel said. […] For keloids, as the knowledge is still growing on how to treat them, Waibel explained that she never tells a patient it wont come back after treatment.

• #2 Keloids: A Review of Etiology, Prevention, and Treatment | JCAD – The Journal of Clinical and Aesthetic Dermatology

  https://jcadonline.com/keloids-scars-treatment-review/

  Beyond simple surgical excision, surgical management of keloids encompasses multiple novel reconstructive techniques that have demonstrated reduced rates of recurrence with treatment-resistant keloids. […] Cryotherapy involves the administration of freezing therapy to keloids to reduce scar volume and recurrence. […] Radiation therapy has been shown to be most effective as an adjunctive therapy to surgical excision compared to monotherapy. […] PDL is a form of nonablative laser therapy that targets keloid microvasculature to improve scar appearance. […] There is evidence that multiple ablative CO2 treatments are necessary for longer-lasting scar improvement. […] Laser-assisted drug delivery (LADD) has been shown to increase drug penetration and decrease the required dosage for optimal efficacy in murine and porcine skin models.

• #2 Radiation therapy for keloid scars

  https://www.genesiscare.com/au/radiation-therapy-for-benign-conditions/keloid-scars

  Radiation therapy may be used to treat keloid scars that can sometimes develop after injury to the skin. […] Management of keloid scars may include one or more different therapies, often used in combination, that help to reduce inflammation in the skin. […] Your specialist may advise you to try certain treatments to help reduce inflammation. If these treatments haven’t worked for you, then careful surgery combined with precision radiation therapy may be appropriate for you. […] Radiation therapy may help treat keloid scars by reducing the inflammation which in turn dampens the excess production of collagen. […] Radiation therapy can be used after surgery, with the aim of preventing the scar from recurring; studies show success rates around 80% to 85% with no regrowth of the scar. […] Radiation therapy for keloid scars can use a technique called electron beam radiation therapy, which is delivered by a linear accelerator (LINAC).

• #2 Keloids: A Review of Etiology, Prevention, and Treatment | JCAD – The Journal of Clinical and Aesthetic Dermatology

  https://jcadonline.com/keloids-scars-treatment-review/

  Used successfully for the treatment of basal cell carcinoma and human papillomavirus-related warts, imiquimod 5% cream has shown promise as an adjuvant therapy for keloids after excision. […] Mitomycin C can reduce keloid recurrence postexcision. […] When used as a monotherapy for keloids, 5-FU has been reported to have a 21 to 35 percent rate of recurrence at a minimum of three months and maintain keloid volume reduction of keloids for at least six months after the last therapy session in 58 to 65 percent of patients. […] Interferon alpha-2b and interferon gamma have been evaluated as therapeutic treatment options for keloids. […] Bleomycin has been shown to suppress collagen synthesis by dermal fibroblasts, increase collagen turnover, and decrease the levels of lysyl-oxidase required for collagen maturation.

• #2 Management of Keloids and Hypertrophic Scars | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0801/p253.html

  Many patients use topical vitamin E (alpha-tocopherol) hoping its antioxidant properties will prevent scars. However, there is little evidence that it is helpful, and some patients develop a contact dermatitis that may delay healing. […] Another over-the-counter option is onion extract topical gels (e.g., Mederma), but limited clinical trials have failed to demonstrate any clinical improvement in scar height, erythema, or pruritis.

• #2 Keloid and Hypertrophic Scar Treatment & Management: Medical Care, Prevention, Standard Treatments

  https://emedicine.medscape.com/article/1057599-treatment

  No single therapeutic modality is best for all keloids. The location, size, and depth of the lesion; the age of the patient; and the past response to treatment determine the type of therapy used. […] Prevention is key, but therapeutic treatment of an existing hypertrophic scar or keloid includes occlusive dressings, compression therapy, intralesional corticosteroid injections, cryosurgery, excision, radiation therapy, laser therapy, interferon (IFN) therapy, 5-fluorouracil (5-FU), doxorubicin, bleomycin, verapamil, retinoic acid, imiquimod 5% cream, tamoxifen, tacrolimus, botulinum toxin, hydrogel scaffold, and over-the-counter treatments (eg, onion extract; combination of hydrocortisone, silicon, and vitamin E). These therapies have been used to reduce the rate of keloid recurrence after surgical excision, with superficial radiation therapy being the most effective.

• #2 Keloid Scar Treatment In Houston | Premier Plastic Surgery

  https://pearlandpps.com/skin-rejuvenation/keloid-scar-treatment/

  Suppose the scar has been determined to be amenable to surgical excision or keloid surgery. In that case, Premier Plastic Surgery has an established protocol that uses lasers and injections as necessary to help prevent the recurrence of the scar once it has been excised. […] During your initial consultation, we will take your detailed medical history, and Dr. Hankins will examine your keloid scar and determine the right treatment plan for you. You and Dr. Hankins will be able to determine whether one or a combination of keloid scar treatments is best for you. […] At Premier Plastic Surgery, our recommended treatment is generally surgical. We enhance the procedure by injecting triamcinolone into the wound at the time of surgery. In selected cases, superficial radiation therapy or SRT can be given within 24 hours after surgery.

• #2 Keloid scars: Self-care

  https://www.aad.org/public/diseases/a-z/keloids-self-care

  Keloids can affect your well-being. Follow these tips from board-certified dermatologists to help prevent keloids from forming. […] The best way to prevent a keloid is to skip getting a piercing on any part of your ears. […] If you still want to try a piercing, here’s what can help reduce your risk of developing a keloid on your ear. Pay close attention to your ears after getting a new piercing. […] If you notice the skin on an earlobe start to thicken, you may be able to prevent a keloid if you act quickly. […] At the first sign of thickening, immediately remove the earring and start wearing a pressure earring instead. […] To get the best results from a pressure earring, you must start wearing it as soon as the skin starts to thicken, and you must wear it for at least 12 (and preferably 20) hours a day for 4 to 6 months.

• #2 Keloid scar – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/keloid-scar/symptoms-causes/syc-20520901

  A keloid scar isn’t harmful to your physical health, but it can cause emotional distress. Prevention or early treatment is key. […] Keloid scar treatment is possible. If you don’t like how a keloid looks or feels, talk with a doctor about how to flatten or remove it. Even with treatment, a keloid can last for years or recur. […] Early treatment can help minimize growth of a keloid. Talk with a doctor soon after you notice a keloid. If you want to treat one that you’ve had for a while, talk with a doctor who specializes in skin conditions (dermatologist). […] If you’re prone to developing keloids, take these preventive self-care tips: […] Your doctor might recommend applying a pressure pad or a silicone gel pad to a wound while it’s healing. […] If you decide to undergo surgery, talk with your doctor about your tendency to develop keloids. Your doctor can use surgical techniques that reduce the risk of developing keloids at the surgical site. After surgery, ask your doctor about postoperative care and follow the instructions carefully.

• #2 Keloid – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507899/

  Radiotherapy – Best utilized as adjuvant therapy 24 to 28 hours following excision. Caution should be used in patients less than 18 years of age and in vulnerable areas such as the head, neck, and breast as it carries an inherent risk of carcinogenesis. […] Laser – Successive sessions using 585 nanometers (nn) pulse-dye laser and 1065 nm neodymium-doped yttrium aluminum garnet (ndYAG) laser have been shown to induce flattening and regression of keloids. […] Other treatments including topical imiquimod following excision, intralesional botox, intralesional bleomycin, intralesional 5-fluorouracil, and silicone gel sheeting have also been reported to be successful in treating keloid scars either alone or in combination with the above modalities. […] It is important to manage patient expectations as all treatments require multiple sessions and do not uniformly result in complete regression of keloid. The most successful treatment results from the use of multiple modalities and tailoring therapy to meet patient needs.

• #3 Keloid Scar Treatments: Do They Work?

  https://www.webmd.com/skin-problems-and-treatments/what-are-treatments-for-keloid-scars

  Keloid Scars Treatment […] Treatment options for keloid scar removal depend on several factors, including its size, location, and whether the scar is causing pain or causing you difficulty moving. The treatment may also depend on how old you are and how old the scar is. Typically, treatments may include: […] Topical silicone treatments to prevent keloids or stop them from growing are available over the counter. Experts theorize that silicone bonds with skin molecules and creates higher surface tension, encouraging the body to reduce collagen production in the area. These products may also help to repair broken blood vessels, reducing redness in scars. […] Dermatologists recommend using silicone-based products for scars for at least 12 hours per day. Silicone gels and sheets work best on small keloids or as a preventative measure on fresh scars.

• #3 Keloid – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507899/

  Keloids remain a therapeutic dilemma. Not only are they difficult to treat but incomplete therapy can lead to a keloid worsening and growing. Therefore, primary prevention is key. Predisposed individuals should avoid elective procedures if possible, especially ear piercing and tattooing. If accidental trauma occurs or surgical interventions are required, there are ways to minimize and perhaps prevent the development of keloid scar. Minimizing wound tension is important to reduce the risk for keloid development. Rapid primary closure and adequate hemostasis are the cited key elements in tension-free wound closure. Prolonged wound stabilization using silicone sheeting also may help reduce tension on wounds. Compression therapy is noted in the literature to reduce keloid development with pressures of 15 to 45 mmHg recommended for more than 23 hours per day for at least 6 months.

• #3 Management of Keloids and Hypertrophic Scars | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0801/p253.html

  If neither silicone nor corticosteroids are effective over 12 months, second-line surgical treatment followed by corticosteroids and possibly silicone sheeting should be considered. The use of corticosteroid injections following keloid surgery reduces the recurrence rate to less than 50 percent. […] A triple keloid therapy combining surgery, corticosteroids, and silicone sheeting has been shown to be even more effective, with only a 12.5 percent recurrence rate after 13 months. […] Imiquimod 5% cream (Aldara), an immune response modifier that enhances healing, has also been used to help prevent keloid recurrence after surgical excision. […] Treatment of keloids with short-pulsed, 585-nm pulsed dye laser has shown limited promise, with a 57 to 83 percent improvement rate. […] Other therapies with limited studies include intralesional verapamil, fluorouracil, bleomycin, and interferon alfa-2b injections. Although all of these have results comparable or sometimes superior to corticosteroid injection and silicone sheeting, the optimal keloid therapy remains undefined.

• #3 Keloid – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507899/

  Several modalities alleviate symptoms of existing keloids: […] Corticosteroids – Intralesional steroids are considered the first line in the treatment of keloid scars. Multiple injections at intervals of 4 to 6 weeks are required. Recommended doses range from 10 to 40 mg/cc of triamcinolone. This may be used alone or in combination with other modalities. Topical ointments and steroid impregnated tapes also have been shown to reduce symptoms of itching and burning. […] Cryotherapy – Delivery via spray, contact, or intralesional-needle cryoprobe all have been described. Multiple treatments are required. Freeze-thaw cycles of 10 to 20 seconds are recommended to achieve scar tissue necrosis. Post-treatment pigmentary alteration makes this method less desirable in darker skin types. […] Surgical excision – Due to high recurrence rate between 45% and 100%, this method should always be paired with an adjuvant therapy such as post-surgical radiation or intralesional steroid injections.

• #3 Medical Treatment for Scars & Keloids | NYU Langone Health

  https://nyulangone.org/conditions/scars-keloids/treatments/medical-treatment-for-scars-keloids

  Dermatologists at NYU Langone understand that noticeable, poorly healed scars can affect how you feel about your appearance, especially if they are located in a highly visible place such as your face or hand. Our doctors offer noninvasive techniques to minimize the appearance of all types of scars and, in some instances, prevent a surgical wound from becoming a hypertrophic scar or keloid. […] Dermatologists may inject a corticosteroid solution directly into a hypertrophic scar or keloid, which may help reduce its size. […] If a hypertrophic scar or keloid develops after surgery, dermatologists recommend getting steroid injections every four to six weeks, limiting the total number of injections to five. […] Superficial external beam radiotherapy is a low-dose radiation treatment that uses highly focused beams of light called superficial X-rays to destroy collagen-producing cells and limit the growth of new ones.

• #3 Management of keloid scars: noninvasive and invasive treatments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8007468/

  Current international guidelines recommend intralesional corticosteroid injections as the first-line therapy for the prevention and treatment of keloids. They can be used alone or in conjunction with other treatments. […] Triamcinolone acetonide is used clinically at concentrations between 10 and 40 mg/mL, with 2 to 3 injections per month administered for 6 months or even longer, depending on the location, size, and volume of the keloid, as well as the individual patients characteristics. […] Surgical excision of keloids is a popular option and is recommended as the first-line treatment if disabling scar contracture is present. However, it should be used with caution since it often creates even larger lesions, and recurrence rates are high (45%100%). Adjuvant measures, such as radiotherapy, interferon, bleomycin, cryotherapy, or corticosteroids, should be applied to avoid recurrence.

• #3 Keloid scar | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/keloid-scar?content_id=CON-20423988

  Low-level X-ray radiation alone or after surgical removal of a keloid can help shrink or minimize the scar tissue. Repeat treatments might be needed. Possible side effects of radiation therapy are skin complications and, in the long term, cancer. […] If your keloid hasn’t responded to other therapies, your doctor might recommend removing it with surgery in combination with other methods. Surgery alone has a recurrence rate of 45% to 100%. […] There are no proven methods of removing keloid scars naturally. Some clinical studies have shown that onion extract used orally or on the skin might possibly be effective in improving the appearance of keloid scars and reducing itchiness and discomfort.

• #3 Keloids and hypertrophic scars – UpToDate

  https://www.uptodate.com/contents/keloids-and-hypertrophic-scars

  Given their relative lack of aggressive behavior, many hypertrophic scars can be successfully treated conservatively. […] Conservative therapies are first-line treatments for hypertrophic scars. They include topical or intralesional corticosteroids, compression therapy, and gel sheeting. […] For small single keloids, we suggest intralesional injection of corticosteroids with or without intralesional injections of chemotherapeutic agents or corticosteroid tape/plaster rather than surgical excision as first-line therapy. […] Small keloids can be completely excised in patients who prefer surgery for cosmetic concerns. However, as surgery alone is associated with a very high risk of recurrence (up to 100 percent), surgical excision should always be combined with postoperative adjuvant therapies, including radiation therapy (in adult patients only), intralesional corticosteroids, or corticosteroid tape/plaster.

• #3 Keloid scars

  https://www.nhs.uk/conditions/keloid-scars/

  A keloid scar is a raised scar left on the skin after a wound has healed. You cannot get rid of it, but treatment can help improve how it looks. […] The GP can recommend treatments to improve how it looks. Getting treatment early may help stop the keloid scar growing. […] You cannot get rid of a keloid scar, but there are treatments that can help improve how it looks and reduce irritation. […] Treatments may include: steroid injections or cream, silicone dressings or gels, cryotherapy (a treatment to freeze the keloid scar), laser therapy. […] Surgery to remove the keloid scar is not usually recommended because it’s likely to grow back bigger.

• #3 Keloid scar – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/keloid-scar/symptoms-causes/syc-20520901

  A keloid scar isn’t harmful to your physical health, but it can cause emotional distress. Prevention or early treatment is key. […] Keloid scar treatment is possible. If you don’t like how a keloid looks or feels, talk with a doctor about how to flatten or remove it. Even with treatment, a keloid can last for years or recur. […] Early treatment can help minimize growth of a keloid. Talk with a doctor soon after you notice a keloid. If you want to treat one that you’ve had for a while, talk with a doctor who specializes in skin conditions (dermatologist). […] If you’re prone to developing keloids, take these preventive self-care tips: […] Your doctor might recommend applying a pressure pad or a silicone gel pad to a wound while it’s healing. […] If you decide to undergo surgery, talk with your doctor about your tendency to develop keloids. Your doctor can use surgical techniques that reduce the risk of developing keloids at the surgical site. After surgery, ask your doctor about postoperative care and follow the instructions carefully.

• #3 How to Get Rid of Keloids: 7 Dos and Don’ts

  https://www.verywellhealth.com/how-to-get-rid-of-keloids-7368224

  Laser therapy is a better option for larger keloid scars. This involves several sessions of pulse-dye laser treatments (commonly used to remove birthmarks). The sessions are separated by 4 to 8 weeks and are often combined with corticosteroid injections. […] Superficial radiation therapy delivers radiation via X-ray. The radiation exposure is far lower than that used for cancer treatment. The procedure is generally painless, penetrating only the surface of the skin. […] A common type of chemotherapy drug, called 5-fluorouracil (5FU), is sometimes used for severe or recurrent keloid scarring, Delivered either by intralesional injection or topical cream, the procedure is considered safe and can substantially improve the appearance of keloid scars. […] Different surgeries can be used to reduce keloid scars. These procedures are commonly performed by plastic surgeons, facial plastic surgeons, and dermatologic surgeons when a scar is disfiguring or other treatments fail. Unlike some procedures (like laser therapy) where recurrence is common, surgical reduction is considered a more permanent solution. […] Harder-to-treat cases may benefit from steroid injections, laser therapy, cryotherapy, superficial radiation therapy, or local chemotherapy. For severe or recurrent keloids, surgical reduction by a plastic surgeon or facial plastic surgeon may be needed.

• #3

  https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=abp9862

  There is no sure cure for keloids, but treatment sometimes improves how they look and feel. It is common for keloids to grow back after treatment. […] When trying to treat a keloid, your doctor may need to use more than one type of treatment. Based on a keloid’s size and location, and how soon it is treated, your doctor may: […] Freeze it. This is called cryotherapy. It is best used for small keloids, such as from acne. Cryotherapy can lighten the skin. […] Inject it with medicine. A corticosteroid is the most commonly used medicine for reducing keloids. It is most likely to work well with cryotherapy or right after surgery. […] Other medicines may improve keloids. These include verapamil, fluorouracil, bleomycin, and interferon alfa-2b shots. They are not as well studied as corticosteroid shots, but your doctor may recommend trying one. They are most likely to work when used with another treatment.

• #4 Keloid Scars: Causes, Treatment, and Prevention

  https://patient.info/skin-conditions/keloid-leaflet

  Keloid scars are an overgrowth of skin after a cut or injury that is larger than the original wound. […] Many patients ask for their keloid scar to be 'cut out’ (surgically excised). This is hardly ever successful and in fact can result in an even bigger keloid scar coming back. Keloids must never be cut out by a GP or by anyone who isn’t medically qualified. They should only be treated by a specialist doctor such as a dermatologist or a plastic surgeon. […] One of the most common methods is injecting steroid (triamcinolone acetonide) and local anaesthetic into the keloid scar itself. The injections are done with a tiny needle, but can be a bit sore. This is called 'intralesional corticosteroid injection treatment’: […] Although the standard treatment is an injection of steroid into the keloid, other injection options now include bleomycin, verapamil, hyaluronic acid and hyaluronidase, botulinum toxin, and collagenase. […] Other treatment options include cryotherapy (using freezing temperatures), laser, radiofrequency ablation, radiation, and shock-wave therapy. […] Removing the keloid by surgery is not usually an option as the keloid will often recur after the surgery.

• #4 Keloids Cryotherapy: Benefits of the Procedure | Miami, FL

  https://www.thekeloidplasticsurgerycenter.com/blog/cryotherapy-keloid-benefits/

  Cryotherapy could be the solution. The keloids cryotherapy benefits include an excellent outcome without pain. […] Cryotherapy is a minimally invasive method of treating keloids without having to resort to surgical procedures. […] Cryotherapy for keloids is a non-invasive treatment with a lot of benefits. […] Cryotherapy is a safe and effective treatment for keloids and hypertrophic scars, especially in darker skin types. […] Studies have shown that external cryotherapy can reduce the rate of recurrence of auricular keloids by up to 50%. […] Unlike surgical interventions for treating keloids, cryotherapy is a non-invasive treatment option without any side effects such as pain or post-procedure recovery time off from work or activities of daily living such as bathing or dressing changes.

• #4 Radiation therapy for keloid scars: Keloid scar treatment | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/radiation-therapy-for-keloid-scars

  Radiation therapy for keloid scars is a non-invasive medical treatment modality for keloid scars, a thick, raised scar extending beyond the original wound edges, using low-dose radiation therapy. […] Radiation therapy for keloid scars is a highly effective treatment method for treating keloid scars or hypertrophic scars using low-dose radiation therapy with few side effects and has very high success rates. […] Radiation therapy for keloid scars after surgery almost always produces satisfactory results. […] The procedure requires only 3 radiation sessions, poses no risk of infection from the surgical incision, reduces the size of the keloid scars, and prevents keloid recurrence effectively. […] Radiation therapy for keloid scars is a treatment for keloid scars that uses low-dose radiation on the superficial or outermost skin layer without penetrating the deeper skin layer.

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