Non-Surgical Options

The majority of Keloids won’t be treated surgically and although there are several non-surgical options available steroid injections into the scar is the most widely used and thought to be the most effective treatment.

Steroid Injection

Steriod injections are commonly used in the treatment of keloids and are often the first treatment patients with keloids receive; they are thought to work in a number of ways to reduce the amount of scar that is formed. The rubbery material that makes up the keloid is made of a protein called collagen which is produced by cells around the scar tissue called fibroblasts (see What are keloids section). Steroids work in part to prevent these cells from producing collagen; they also help to weaken the scar encouraging it to flatten, as well as this steroid injections also reduce the itchiness and tenderness of the scar if present. A number of large studies have demonstrated the usefulness of Steroids in treating keloids.

Steroid injections are given in cycles with their normally being between 4-8 weeks between injections, undergoing steroid treatment would require the patient visiting the clinic a number of times to complete the cycle . These injections are often described as “INTRALESIONAL STERIOD INJECTIONS” this simply means that the steroid is injected directly into the keloid scar and not around it. Steroids injections may be used on their own or in conjunction with surgery or other therapies and if undergoing surgery it may be required to continue steroid injections.

Steroid injections may have a number of complications depending on how much the patient receives. These include thinning of the skin, slight changes in skin colour (either becoming lighter or darker), telangiectasia may form, these are small blood vessels which enlarge and can be seen on the skin, there can also be wasting of the tissues beneath the skin. After steroid injection- Keloid scars can become hypo pigmented or variably coloured.

Example of variation in skin colour after steroid injection:

Compression

Dressings which apply a limited amount of pressure to the site of the scar have been found to be of some use in treating keloids. They can be used for as both parts of a treatment plan or as a preventative measure after surgery to remove keloids. There are very few side effects to this type of therapy but it may be required for patients to wear the dressings for long periods of time (between 12-24 hours a day for a couple of months). They are thought to be most useful in patients whom have had surgical excision of keloids from their ears.

Compression treatments include button compression, pressure earrings, ACE bandages, elastic adhesive bandages, compression wraps, Lycra bandages, and support bandages. Other pressure devices include pressure earrings and pressure-gradient garments made of lightweight porous Dacron, spandex (also known as elastane), or bobbinet fabric (usually worn 12-24 h/d) and zinc oxide adhesive plaster.

Silicon gels + sheets

Silicon gels have been shown to be able to reduce abnormal scarring including Keloids. They are available both as a topical gel which can be rubbed onto the skin or as elastic sheets with the gel impregnated onto it. These types of gels can be used in conjunction with other therapies or after surgical removal of the keloid. It is uncertain how they work, although it is thought that they may provide a protective layer around the scar keeping it hydrated.

Camouflage

A camouflaging service is available as part of the service provided by the Clinic, it is headed up by Lynn Salim a nurse specialist working with the team. For more information please visit our Camouflage Clinic.