III.
Treatment:
There is no satisfactory keloid
treatment.
Some doctors have had
success injecting keloids with bleomycin, an anticancer drug.
The most accepted keloid treatment is to
inject a long-acting cortisone into the keloid once a month. After several
injections with cortisone, the keloid usually becomes less noticeable and
flattens in three to six months time.
A new keloid
treatment is to apply a silicone gel preparation over the keloid scar for 12-24
hours each day. This treatment is started three to four weeks after the wound
or injury. The gel preparation should be covered with an ace bandage, cloth
wrap, or tape and changed every 7-10 days based upon need. The gel can be
washed and used over each day. An even newer form of silicone that is more
convenient is Scar Guard
(applied like nail polish and contains cortisone, Vitamin E and silicone).
With daily use, the keloid will become flatter and smoother within two to
twelve months.
Surgery is always an
option but one must remember – the keloid can always come back – sometimes
even bigger! Most patients need to be watched after surgery to assess the
need for cortisone shots if it looks like the keloid is coming back. That is
why follow-up appointments are very important. More aggressive treatment
includes radiation therapy after surgery to decrease recurrence rates.
Very recently, pre-treatment with Retin-A cream 3 weeks
prior to surgical removal has been noted to dramatically reduce the incidence
of recurrence.
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