What is a keloid scar?

Do you require keloid scarring treatment?

Step-by-Step Approach to Treating Keloid Scars

Corticosteroid Injections

  • Intralesional Steroids: Corticosteroids such as triamcinolone are injected directly into the keloid to reduce inflammation, suppress collagen synthesis, and flatten the scar. Multiple sessions spaced 4–6 weeks apart may be needed to achieve optimal results.
  • Combination: Steroid injections can be used alongside silicone therapy or after surgery to enhance outcomes.

Triple Therapy

  • Combination of Surgery, Steroids, and Radiation: For stubborn or recurrent keloids, triple therapy is often recommended. Surgery reduces the bulk of the keloid, followed by steroid injections and low-dose radiation to minimise recurrence.
  • Post-Surgical Care: Silicone sheets and pressure therapy are essential during the healing phase to ensure the keloid does not regrow.

Surgical Treatment (Debulking Surgery)

  • Debulking Rather Than Complete Excision: The primary goal of surgery is not complete excision, as this increases the risk of recurrence, but rather a reduction in the size and thickness of the keloid. Debulking preserves some of the scar tissue while alleviating symptoms like pain or itching and improving appearance.
  • Adjunctive Measures: Following debulking surgery, corticosteroid injections, silicone therapy, or radiation are initiated immediately to suppress fibroblast activity and prevent the recurrence of excess tissue growth. The patient continues with pressure therapy and other non-invasive methods to maintain results.

Benefits and Long-Term Results

The stepwise treatment approach ensures tailored interventions for each patient. Early conservative therapies help manage smaller or less symptomatic keloids, while surgical debulking paired with adjunctive treatments provides a solution for larger or more advanced scars. This approach minimises recurrence and offers long-term improvements in both function and appearance. By combining treatments, the risk of regrowth is significantly reduced, resulting in smoother, less noticeable scars.

After your procedure:

Conclusion

Keloid scar management requires a structured and multimodal approach. Surgical debulking, combined with adjunctive therapies, is highly effective for larger or recurrent keloids. By focusing on early interventions and comprehensive post-surgical care, patients can achieve lasting improvements in aesthetics and comfort, enhancing their overall quality of life.

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