Treatment of keloids

Written by Liu Gang
Dermatology
Updated on September 04, 2024
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The formation of keloids is somewhat related to an individual's scar constitution. Once keloids have formed, there is a lack of a perfectly effective treatment plan. The most commonly used treatments are topical ointments, which can't completely solve the problem. The most frequent treatment involves local application of steroid medications, which can be chosen based on the size of the keloid to be treated 2-3 times, or even four to five times. After treatment, the keloids will gradually shrink, become softer, and smaller, but they will not completely disappear. If the keloid proliferation is not particularly severe, one can also visit a dermatology department at a formal hospital to use fractional laser treatment. Currently, there are many other drug treatments available, but their ultimate effects are not certain, so it is best to prevent such conditions in individuals prone to keloids, avoiding external injuries or scars.

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What should I do about auricular keloids?

Auricular keloids are a relatively common clinical condition, which may be related to an individual's scar constitution. Firstly, it is necessary to examine the size of the keloid. If the keloid is small, without obvious enlarging, redness, pain, infection, or inflammation, this situation generally can be considered for observation followed by regular ENT (ear, nose, and throat) specialist follow-ups to check for any rapid growth. However, if the keloid is large and progressively growing, surgical removal should be considered. After the surgery, local superficial radiation therapy can be considered to help prevent postoperative recurrence.

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Can hypertrophic scars be effectively treated?

Hypertrophic scars are related to constitutional issues, generally directly associated with congenital genetic factors. Thus, while it is possible to improve the condition of hypertrophic scars, it is impossible to completely remove them, as altering such constitutional issues entirely is very challenging. When dealing with hypertrophic scars, one can choose various methods to alleviate the condition, such as improving local tissue vitality through massage, which can promote skin regeneration and thus mitigate the effects of hypertrophic scars. Additionally, treatments for hypertrophic scars can include laser surgery or the use of medications that invigorate blood circulation and disperse blood stasis. Importantly, preventing wounds and thus avoiding scar formation is crucial for optimal prevention. (Use medication under the guidance of a doctor, and do not self-medicate).

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How to remove keloids?

The formation of keloids is largely related to one's inherent scarring constitution. Some patients are not prone to keloids but can still develop them due to particularly deep or large wounds. Additionally, keloids can form on the chest or shoulders after repeated occurrences of folliculitis. Currently, there are not many treatments for keloids. For larger keloids, medication can be used locally to gradually soften and reduce their size. For smaller areas, cosmetic surgical methods can be employed for removal, although this does not guarantee prevention of recurrence. Once keloids appear, they are mostly irreversible. If the keloid grows rapidly, treatment can also be sought at nuclear medicine departments, where nuclear radiation therapy is used.

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What will happen if hypertrophic scars are not treated?

Hypertrophic scars are actually related to individual constitution. This condition mainly occurs due to scarring following an injury, which leads to excessive growth of scar tissue. As long as there are no inflammatory changes, generally, hypertrophic scars do not cause any problems. However, some hypertrophic scars may develop into malignant lesions, particularly in areas that are easily stimulated, such as the soles of the feet or the armpits. If a hypertrophic scar persists and the area is continually stimulated, it may lead to changes in the scar, which, in severe cases, could even become malignant. In such situations, it is crucial to manage the condition promptly based on the specific circumstances. Safe treatment measures usually involve techniques such as laser surgery.

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Can keloids be cured?

Once keloids appear, they are essentially irreversible, meaning that they cannot be completely cured clinically. The formation of keloids is mostly related to one's own constitution, such as a keloid-prone skin type. Some keloids are also due to trauma occurring in areas of the skin where muscular tension is relatively high, or where the wound is indeed large and deep, which might lead to the formation of keloids. In such cases, localized drug injections can be used to reduce and soften the keloids. One can also use ointments that soften scars, such as keloid soothing and softening cream, but these require long-term application to be effective. If the keloid is relatively small, cosmetic surgery to remove and re-sew the area can also be an option for treatment. In summary, once keloids have developed, they are not easy to completely cure.