keloid scar treatments therapy

keloid scar treatments

A keloid is a special type of scar which typically appears in younger people on certain areas: earlobes, neck, shoulders and breasts. It can appear in other areas but it is rarely the case. Main cause of their development is an injury of any kind, and there are cases when they develop spontaneously without any trauma. There is also a genetic tendency for their development. Apart from being an aesthetic problem  keloids cause a number of issues: pain, sensitivity, itching and uneasiness. 

A keloid is a benign formation of connective tissue where certain types of collagen are of abnormal quantity. It behaves as a tumor because it doesn't have growth control of cells. In keloids cells, instead of withering, uncontrollably multiply. 

Where do keloids develop the most?

Theoretically they can develop anywhere on one's body, but there are areas which are affected more:

  • neck
  • shoulders
  • ear lobes
  • breasts 

What is the difference between a keloid and a scar?

Differently from a regular scar, keloid is outside the injury area, it never disappears and has a tendency to return after a treatment, it itches and is painful and sensitive to the touch. It represents an aesthetic but sometimes a health problem because it can limit movement if in the joint area because of its size. Keloid forms a connective tissue which is extremely dense and hard to the touch. Usually it is of red color because of many blood vessels which are inside it. It is advises, if not necessary, not to operate or perform procedures in risky areas and check on the family tendency towards keloids. 

Therapy

Keloid therapy is the greatest challenge in aesthetic-corrective medicine. The usual keloid therapy is freezing, surgery, radiotherapy, interferons, corticosteroids, silicone patches, vitamin E, cytostatics … Satisfying results in keloid reduction can be achieved, but unfortunately the possibility of them returning cannot be overruled. They are unpredictable. A novelty in their therapy are lasers. By destroying blood vessels the red color disappears, as does pain, sensitivity and uneasiness to the touch. Final result is smoothing and softening of the keloid. It is considered that lasers have an anti-inflammatory effect and that is why keloids stop hurting and itching. The most important laser effect is the destruction of blood vessels which feed the keloid and it withers in that way. At the same time the laser changes the abnormal connective tissue in the keloid for normal one. Treatment of choice is a combination of lasers and intralesional corticosteroids which prevent the enhanced development of connective tissue. Unfortunately, the number of needed treatments cannot be predicted. If a keloid is in an active phase results are poor. When treating an inactive keloid we can achieve very good results. Generally, we can say that the more older the keloid is the better the  results. The interval between treatments is 2 to 4 weeks. 

Cold ablation

The method is based on heat destruction of scars which then peel of in layers. There is an exchange of abnormal connective tissue within keloids and hypetrophic (elevated) scars. The goal of the treatment is to smooth the scar or a keloid. This method is a bit unpleasant but extremely quick and  ensures good results. 

Non-ablative fractional lasers

This laser works in the same way as a fractional (ablative) laser but does not damage the skin  surface and affects only superficial areas. The laser heats the water in the tissue to a high temperature causing damages of the connective tissue. The organism will dispose of the damaged tissue and create a new one to replace the scar or a keloid. In that way smoothing and softening of the keloid is achieved. The treatment is not painful. 

Neodymium Yag laser

The laser goes over the keloid a couple of times. The goal is to soften the keloid and destroy blood vessels in it. The treatment is painless. The number of treatments cannot be predicted but results are visible after the initial treatment. The interval between the treatments is 7 to 30 days. A keloid can be softened and leveled with the laser and redness removed. Itching and pain also disappear. 

Intralesional corticosteroid injection

The goal is to decrease the enhanced development and whithering of the connective tissue by injecting corticosteroids into the keloid. This treatment is recommended immediately after the Neodymium Yag laser which softened the keloid and makes the injection easier to perform. 

AFT treatment

Blood vessels which feed the keloid are destroyed with optical energy and inflammation is removed. It is recommended to combine the treatment with a Neodymium Yag laser. Immediately after the treatment significant results are visible in the sense that the keloid is not as red, is smoother and in level. 

Pulsed Dye laser

The laser destroys blood vessels and makes the keloid smaller because connective tissue doesn't have anything to feed on and whithers. Generally, this laser type gives really good results.

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