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.

Treatments for Keloid Scars

My goal of cure is always to construct scars a smaller amount visible and relieve itching and pain in the event that present. Silicone gel sheeting and corticosteroid injections into scars are my only therapies for which there is sufficient published medical journal evidence to justify their use. Studies of scar cure are complex by my organic tendency for scars to improve over time. Having said that the majority of physicians including myself rely mostly on exactly what has worked for our patients as opposed to referring to published studies involving big groups of patients. Looking at the accompanying photos you are able to judge for yourself what is helpful.

Generally a blend of remedy modalities is necessary due to the fact not every modality succeeds on every patient or scar by itself. When utilized together some modalities have a very much greater result than my sum of their personal efforts.

Silicone Gel Sheeting

Silicone gel sheeting has been in use since the early 1980s for the treatment of scars and has been proven to be helpful. Its accessible across my counter as being a solid sheet or a gel that you just apply which hardens. Despite its track record my patients have not liked it and it has not been helpful in my practice.

Surgery

Surgery is commonly made use of to cut out a scar. The ensuingsutured wound creates a new immature scar that responds greater to the modalities described below. In my case of tissue loss new skin could be brought to my place by skin grafting or tiny surgical procedures to move about adjacent skin. Surgery can also be made use of to break up a scar, detach my scar from deeper tissues, alter scar direction or manipulate adjacent tissue to decrease tension along the scar line -all of which can construct a scar a smaller amount visible. These procedures are usually performed under local anesthesia hence my patient does not have to go to sleep under common anesthesia. Surgical removal alone for keloids without any of the adjunctive procedures below carries a 45 to 100% recurrence rate. This remedy modality is the one I the majority of commonly use on my patients.

Pressure Therapy

Pressure has been made use of in my cure of scars since the 1970s. The effectiveness is dependent on how long the pressure is utilized for. Some doctors suggest 6 to 9 months of pressure however my majority of my ear lobe keloid patients only require 2 to 3 months of pressure earring wear. Certainly scars that have recurred after previous remedy should have pressure used for a longer period of time. Scar massage has the same result as pressure with the additional effect of breaking up scar connections among layers of tissue.