Tuesday, January 26, 2010

Treatments of Keloids Without Surgery

The practical application of mechanical pressure by compression devices is strongly suggested when considering the cure of keloids. Pressure may possibly in theory break up collagen packages and soften the keloid mass; however it is important to realize that the therapy needs to be instituted for long periods (>23 h/d for 6 mo) before any major effects are usually achieved. Sadly, numerous regions in the head and neck are not amenable to pressure use. Silicone sheeting is utilised to decrease irritation and pruritus related to keloids. The proposed mechanism of action involves upkeep of scar hydration and inducement of a subsequent decrease in cytokine release, producing in fewer collagen deposition. Specific authors report great achievement in keloid regression with this modality. But, my general opinion on silicone sheeting does not cause major reduction inside the dimensions or pigment characteristics of keloids, however silicone sheeting might be very effective in decreasing pruritus.

Several therapies, such as retinoic acids, nitrogen mustard, antihistamines, tetroquinone, zinc, vitamin A, vitamin E, and verapamil, have been used with different levels of accomplishment.

Interferon (IFN) therapy is made use of due to of its power to lower collagen synthesis in dermal fibroblasts. Granstein et al reported a 30% reduction in keloid height right after intralesional injections of IFN-gamma 3 times weekly for 3 weeks.4 As with other treatment modalities, some recurrences may be to be predictable. IFN can have unfavorable outcomes like, a flulike illness for 48-72 hours after receiving the injection, low-grade fevers and pain on injection.

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