Treatment

The best initial treatment is to inject long-acting cortisone (steroid) into the keloid once a month. After several injections with cortisone, the keloid usually becomes less noticeable and flattens in three to six month's time. Hypertrophic scars often respond completely, but keloids and are notoriously difficult to treat, with recurrences commonly seen. People who have a
family history of keloids have a higher rate of recurrence after treatment.

Cryosurgery is an excellent treatment for keloids that are small and occur on lightly pigmented skin. It is often combined with monthly cortisone injections. Earlobe keloids are often surgically excised and followed with several steroid injections. Recently, a new drug called alpha-interferon has been injected into the scar immediately after keloid removal with very promising results. Laser treatment is very good at improving skin texture and color, but doesn't always flatten out the keloid.

For severe cases, the keloid can surgically excised and given x-ray treatments to the site immediately afterwards, usually the on the same day. This works in about 85% of the most severe cases. Electron beam radiation can be used, which will not go deep enough to affect internal organs. Orthovoltage radiation is more penetrating and slightly more effective. There have not been any reports of this causing any form of cancer in many years of use, but it is very expensive. Silicone pads and creams are sold for use on keloids. These do benefit hypertrophic scars but will not cure a true keloid. However, they can reduce pain, swelling and itching from a keloid. They usually take 3 months or more to work.

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