Keloid Scar Treatment
Keloid scars are raised, thick scars that develop as part of the body’s natural healing process in response to an injury, infection, burn, or inflammation. These scars occur due to excess collagen produced during the healing process and continue to grow beyond the limits of the initial trauma after the skin has healed. While scarring is natural, keloid scars can be painful, itchy, and uncomfortable, and their appearance can negatively impact one’s self-esteem and confidence. Unlike other types of scars, keloid scars do not go away on their own. Luckily, Dr. Michele Green in New York City is an expert at improving the appearance of keloid scars.
There are various types of nonsurgical and surgical options available for keloid scar treatment. Corticosteroid injections, cryotherapy, and radiotherapy can all help to flatten and shrink keloid scars. Pulsed-dye lasers such as the VBeam laser are used to reduce red pigmentation from the scar. In some cases, surgical excision of the keloid scar may also be recommended. Silicone gel sheets and pressure garments are used after treatment to prevent the keloid from reforming. These treatments require multiple sessions and are often used in conjunction with one another to achieve the best cosmetic results. As recurrence rates after keloid scar treatments are incredibly high, it is essential to consult with an expert such as Dr. Green, who will create a combination treatment approach for your keloid scars to leave you with clear, radiant skin.
Dr. Michele Green is a world-renowned board-certified dermatologist with over two and a half decades of experience providing some of the world’s most discerning individuals with the best non-invasive cosmetic procedures, including VBeam laser treatment and intralesional corticosteroid injections for keloid scars. She is consistently identified as one of New York’s best dermatologists by Super Doctors, Castle Connolly, and New York Magazine due to her expertise and dedication to her patients. When you consult with Dr. Green at her private dermatology office in Manhattan’s Upper East Side neighborhood regarding keloid scar treatment, she will work with you to create a customized scar treatment plan that best suits your skin type, location and size of the scar, and your overall aesthetic goals.
Why do scars form?
Scars form during the healing process as a result of the body’s natural healing process after a wound is damaged or cut. Many kinds of scars can form due to various adverse events, and these injuries can result in the appearance of various scars. If the injury to the skin goes deeper than the top layer, the scar tissue that forms is often thicker than normal skin. For patients with a lighter skin tone, scars are typically pink or red when they initially develop and may fade away with time or become darker or lighter than the patient’s regular skin color. For patients with darker skin, scars can frequently look like dark marks on the skin’s surface. A scar can form on any part of the body, and the type of scar depends mainly on the origin of the injury or lesion, how your body heals, and the formation of the wound.
What is a keloid scar?
A keloid is a type of hypertrophic scar that is firm, raised, and growth-like in appearance. A hypertrophic scar is a thick, raised scar that forms due to an excessive amount of collagen produced during the healing process. Unlike normal hypertrophic scars, keloids can continue to grow after the skin trauma has healed to extend beyond the limits of the original wound. The color of keloid scars can vary and may change over time as the scar develops. Keloids may be flesh-colored, erythematous, or hyperpigmented. Keloids are benign growths that may cause burning, itching, or pain in the affected area. Keloids do not resolve on their own or regress over time. They can be an especially challenging type of scar to treat, and successfully reducing them requires treatment by a plastic surgeon or board-certified dermatologist like Dr. Michele Green in New York City.
How do keloids form?
Keloid scars form due to an abnormal amount of excess collagen production that occurs during the wound-healing process. Collagen is a structural skin protein contributing to a firm foundation and an overall youthful appearance. A keloid can form when the body produces more collagen than is needed to heal a wound. A keloid scar extends beyond the limits of the initial injury and does not regress over time, unlike normal hypertrophic scars. Keloids may form as a response to surgery, piercings, acne, tattooing, insect bites, burns, lacerations, abrasions, vaccinations, and any other process that results in skin inflammation. Some individuals are more prone to developing keloid scars. Dark-skinned individuals have higher rates of keloid development, and a family history of keloids increases the risk for their development. Keloids may develop on any body part but are most commonly found on the chest, shoulders, cheeks, and earlobes.
Who can get keloid scars?
While anyone can develop a keloid scar after an injury, some individuals are more prone to them. A large risk factor for keloid scar formation includes having a family history of keloids, as there may be a genetic component to them. Individuals with darker-pigmented skin tones, such as African, Asian, and Hispanic skin, typically form keloid scars at a larger rate compared to individuals with lighter skin tones. Individuals who have previously had keloids or who have a wound that is taking longer to heal are also at higher risk of developing keloid scars. Surgeries involving mesh skin grafts, which help transfer healthy skin from one part of the body to another, can increase the risk of developing keloid scars. Lastly, events such as puberty or pregnancy can lead to an increased risk of keloid scars, as hormonal changes during these events may affect the healing process of wounds.
What are the first steps in keloid scar treatments?
The first step in treating keloid scars is to consult with an expert such as Dr. Green, who will assess your keloid scar and determine the best treatment for you. Keloid scars can be particularly challenging to treat, as many of the therapies are associated with high recurrence rates. An expert such as Dr. Green will often employ a combination approach to keloid treatment to reduce the appearance of and eliminate your keloid scars.
Topical treatments
Silicone gel sheets are a standard topical treatment for keloid scars. Made from medical-grade silicone, these sheets can be used on a recent wound or a new keloid to prevent raised scars from forming and flatten keloids. Researchers have found that though silicone ointment is also available, silicone sheets are more effective at preventing scarring. Silicone gel sheets should never be applied on an open wound or a scab – once the wound is healed, the silicon gel sheets can then be applied. In some cases, a dermatologist may recommend applying silicone sheets after a treatment like keloid surgery to prevent the keloid from reforming.
A pressure garment can also be applied after keloid treatment to reduce the risk of recurrence. By applying constant pressure to the site, pressure garments limit the amount of scar tissue formed during the healing process, preventing keloid formation. Pressure garments are often used after treatments such as cortisone injections and keloid surgery. Pressure earrings are also available when treating keloids on the earlobe from an ear piercing.
Intralesional injections (Corticosteroids, Bleomycin, Fluorouracil)
Corticosteroid injections, more commonly known as steroid injections, are very different from the kind of steroids you may hear about in the media regarding bodybuilders. Corticosteroids are synthetic drugs similar to hormones that appear naturally in the body. These corticosteroids are injected directly into the treatment area to decrease the size and thickness of keloid scars, making them appear smaller and flatter. Corticosteroid injections often involve a series of treatments to flatten the keloid, although patients may notice their keloid feels softer after their first treatment. Typically, 50-80% of keloid scars respond to corticosteroid injections and shrink after treatment.
Two newer intralesional therapies for keloid scars include bleomycin and fluorouracil. Bleomycin is an anti-cancer medication typically used to destroy fast-diving cells such as cancer cells. More recently, bleomycin has also been used to treat hypertrophic and keloid scars, as it can inhibit collagen synthesis. Fluorouracil is another anti-cancer drug used to treat precancers like actinic keratosis or skin cancers like basal cell carcinomas. Fluorouracil inhibits cells from making DNA and proteins and can reduce collagen synthesis to decrease keloid scars.
VBeam laser
Laser treatments are often used in scar revision to improve the color and texture of scars. The V-Beam laser is popular in laser therapy scar revision as it is the gold standard for eliminating red pigment from the skin. The V-Beam laser is a pulsed-dye laser that can treat post-inflammatory hyperpigmentation, stretch marks, acne scars, surgical scars, and broken blood vessels and capillaries. By targeting the vascular component in keloid scars, the V-Beam laser can improve the texture, tone, and pigmentation of the scars to reduce their appearance. Multiple treatment sessions spaced one month apart are typically required for the best cosmetic results. The V-Beam is often used in combination with other therapies, such as corticosteroid injections, to reduce the appearance of and eliminate keloids.
Surgical excision
In some cases, surgical excision may be the best option for keloid treatment. Surgical removal of keloids can be effective for patients suffering from a significant keloid scar that is very large, has grown such that it limits movement, or does not respond to any nonsurgical treatments. It is important to note that keloid surgery has a very high recurrence rate due to the amount of skin injury associated with the surgery. Your plastic surgeon may recommend pressure garments, silicone gel sheets, or corticosteroid injections following surgery to reduce the risk of the keloid reforming. Any surgical procedure poses more significant side effects and infection risks than non-surgical treatments, and it is important to weigh all of the benefits and risks when considering the surgical excision of keloids.
Cryotherapy
Cryotherapy involves applying a cooling agent, such as liquid nitrogen, to freeze the keloid immediately upon contact and reduce the size and firmness of the scar. The keloid may blister or scab within a few days after treatment, and proper wound care will be addressed to help minimize scarring. Cryotherapy is not an effective treatment for darker-pigmented skin, as it can cause permanent light or brown spots after treatment. Cryotherapy is also best for small keloids. Typically, multiple sessions of cryotherapy are necessary to achieve the best results from treatment. Cryotherapy may also be used after surgical excision or corticosteroid injections to help reduce scar tissue formation.
Radiation therapy
Radiation therapy, or radiotherapy, used to be one of the most common treatments for preventing keloid formation after performing a keloid treatment like surgery. Radiation damages DNA, causing cell death in keloids and shrinking of the scars. In the past, radiotherapy treatment led to itching, peeling, and permanent color changes in the skin. Some patients also reported developing cancer after keloid radiotherapy treatment. Today, dermatologists have worked with oncologists to develop superficial radiation therapy (SRT) that uses safety measures, such as proper dosing and protecting non-targeted body areas, to ensure safe keloid treatment and reduce cancer risk.
Are keloid scars permanent?
Yes, keloid scars are permanent. Keloid scars grow outside of the original injury site and can form months or years after the initial injury. Without any type of intervention, keloid scars will not go away on their own. Luckily, Dr. Green offers many different types of keloid scar treatments in her private NYC dermatology office to reduce the size or appearance of the keloid scarring or eliminate it permanently.
Are keloid scars dangerous?
No, keloid scars are not dangerous at all! Keloid scars are formed due to an excess production of collagen, a skin protein used to heal wounds. While keloids can look distressing and be itchy, painful, or distressing, they are not any cause for concern. A skilled dermatologist such as Dr. Green can diagnose a keloid scar from sight and generally will not need to conduct a skin biopsy. If it looks like you may have another skin condition, Dr. Green can perform a skin biopsy for further examination. The biopsy will be sent to a dermatopathologist, who will assess the sample for any malignancy.
How to remove a keloid from a piercing
Keloid scars commonly form after piercings, especially in individuals with darker skin tones, those who have had keloids before, or those with a family history of keloid scars. Although a keloid scar from a piercing can create discomfort or itching, it generally does not hurt. Irritation is also common with keloids from piercings, as these scars can often be rubbed or touched. A reputable piercer or professional should perform piercings, and after-care instructions should be followed to reduce the risk of developing a keloid. Pressure garments or silicon gel sheets may be recommended if the skin around the piercing begins to thicken. Other treatments, such as corticosteroid injections or V-Beam laser treatment, can also be performed to reduce the size and appearance of the keloid.
How to get rid of keloids on ear
Keloids can appear on the ear and surrounding skin after a wound, such as a piercing, scratch, bug bite, tattoo, cut, or burn. Ear keloids are extremely common and can develop very slowly, sometimes three to twelve months after the injury to the skin. If the skin on the earlobe or cartilage begins to thicken around the wound, a pressure earring can be worn to prevent a keloid from forming. In order for pressure earrings to be effective, they must be worn throughout the day for six to twelve months. Other therapy modalities, such as intralesional injections or surgical excision, can also be performed based on the size and severity of the keloid scar.
How to get rid of keloid scar on nose
Nose piercing bumps are extremely common after a nose piercing. The bump can be a result of inflammation, infection, allergic reaction, or tissue damage. While less common, a keloid scar can develop around the piercing due to excess collagen production during healing. A keloid on the nose can appear as a raised, tender, itchy bump that is darker than the surrounding skin. As growth on the nose can be a result of various factors, consulting with an expert dermatologist such as Dr. Green is best to confirm if the growth is a keloid scar and tailor a treatment plan suited to your specific keloid scar. A series of corticosteroid injections and V-Beam laser treatments can help to reduce the red pigmentation and size of the scar to soften and eliminate the keloid.
How to get rid of keloid inside nose
Although uncommon, keloid scars can form inside the nose, typically as a result of a nose piercing. If a keloid does occur inside the nose, it is important to have it treated as soon as possible, as it can become ulcerated (fester and become painful) and affect the sinuses. Depending on the size and location of the scar, surgical intervention or non-surgical intralesional injections can be used to treat a keloid scar inside the nose.
How to get rid of navel piercing keloid
As with any body piercing, a naval piercing can form a keloid scar due to the injury on the skin. Keloid scars after a naval piercing can form months after the initial piercing. They can begin as red or pink and eventually turn darker than the surrounding skin. When the skin surrounding the piercing begins to thicken, silicone gel sheets can be used in conjunction with pressure garments to prevent a keloid from forming. The VBeam laser and corticosteroid injections are often used in combination to flatten, shrink, and reduce red pigmentation in navel-piercing keloid scars.
Will a keloid scar go away?
Unfortunately, keloid scars do not go away on their own. Keloid scars are a result of excess collagen produced during the wound-healing process. Unlike typical hypertrophic scars, keloid scars can take months to form after the initial injury and grow past the initial site of the wound. Without medical intervention, keloid scars will not go away on their own. Luckily, treatments such as intralesional injections, VBeam laser, cryotherapy, silicone gel sheets, and surgical excision are all available to treat and eliminate keloid scars.
Can you treat keloids at home?
Unfortunately, keloid scars typically cannot be treated at home. After a wound or injury to the skin, silicon gel sheets and pressure garments can be applied to the site to prevent the formation of a keloid. However, once a keloid forms, it will not go away without some form of intervention. Some individuals claim that onion extract orally or on the skin can help to reduce keloid formation. These claims are mostly anecdotal and have not yet been proven by clinical research. For a safe and effective keloid scar treatment, consult with Dr. Green in her private Upper East Side dermatology office to discuss the best treatment for your keloid scar.
Can a keloid scar be removed?
Yes, keloid scars can be removed using various treatment methods, depending on their size, location, and severity. Some treatments commonly used for keloid scars include intralesional corticosteroid injections, pulsed-dye laser treatments, and surgical excision. A board-certified dermatologist such as Dr. Green will review your medical history and keloid scar to determine the best treatment options for removal. Typically, keloid scar removal requires a combination approach to treatment, as treatments often have a high recurrence rate.
How to fix keloid scars
While keloid scars are harmless, their presence can be frustrating and embarrassing for those affected by them. Keloid scars can occur anywhere on the body at a site of injury as thick, raised, shiny growths. Unlike other hypertrophic scars, keloid scars will not go away on their own. Luckily, therapies such as silicone gel sheets, pressure dressings, corticosteroid injections, VBeam laser, cryotherapy, and surgical excision are all available to help prevent and reduce the appearance of keloid scars. If you have a keloid scar from a surgery, wound, acne scar, or piercing and are ready to eliminate it for good, Dr. Green is here to help.
Dr. Michele Green is an internationally renowned board-certified dermatologist with over two and a half decades of experience providing some of the world’s most discerning men and women with the best non-invasive cosmetic procedures available, including V-Beam laser and corticosteroid injections for keloid scar treatments. She is consistently identified as one of New York’s best dermatologists by Castle Connolly, New York Magazine, The New York Times, and Super Doctors for her dedication to her patients and expertise. When you consult with Dr. Green at her private dermatology office in Manhattan’s Upper East Side neighborhood, she will work with you to develop a customized keloid scar treatment plan that best suits your needs and goals. To schedule a consultation with Dr. Green, please contact us online today or call the office at 212-535-3088 to see which treatment options will work best for you.