Keloids – are you at risk?

Keloids are raised, thickened scars that form when the skin heals from an injury. They are more common in people with dark skin, especially those of African, Asian, or Latin-American descent. They can be caused by various factors, such as burns, cuts, piercings, acne, or surgery. Keloids can be itchy, painful, or cosmetically bothersome. They can also grow larger over time and affect the normal function of the skin.

One of the common treatments for keloids is steroid injections¹. Steroids are anti-inflammatory drugs that can reduce the production of collagen and proteins that make up the scar tissue. By injecting steroids directly into the keloid, the scar can become softer and flatter over time. Steroid injections can also help relieve the symptoms of keloids, such as itchiness and discomfort.

Steroid injections are usually given by a doctor or a dermatologist in a clinic or hospital setting. The procedure involves inserting a thin needle into the thickest part of the keloid and injecting a small amount of steroid solution. The injection is painful and may be repeated at intervals of 3 to 6 weeks until the desired result is achieved. The dosage and frequency of injections depend on the size, location, and severity of the keloid.

Steroid injections are not a cure for keloids. They can only improve the appearance and symptoms of the scar, but they cannot eliminate it completely. Some keloids may recur or grow back after the treatment, sometimes bigger than before. Steroid injections may also cause some side effects, such as skin thinning, color changes, spider veins, or tissue atrophy (indentations in the skin). These side effects may be temporary or permanent, depending on the amount and duration of steroid use.

Steroid injections are often used in combination with other treatments for keloids, such as surgery², cryotherapy² (freezing), laser therapy², or radiation therapy². These treatments can help remove or shrink the keloid tissue and prevent its recurrence. However, they do require one or more visits to a clinic and may also have their own risks and limitations.

Cost may also be a factor when deciding a course of therapy for a keloid. Most health insurance policies do not cover keloid therapy or treatment. For in-clinic treatments, out-of-pocket costs can range from $250 to $2500 depending on the type, size, and location of the keloid, as well as the number of sessions required.

Newer non-surgical, non-injection, @home treatment options have become available as a first line therapy in recent years to help prevent or treat existing keloids. These include advanced silicone sheet-based technologies from Neodyne Biosciences or CicaLux Inc. (See Fig. 1). These over-the-counter devices range from $70-$150.

Figure 1: 3-yr old c-section Keloid treated by CicaLux.