What are Keloid Scars?
The Institute for Advanced Reconstruction specializes in the removal of keloids. Keloid scars are benign but aggressive proliferative scarring that continuously grows beyond the confines of the original wound and invades surrounding healthy tissue. Keloids are different from hypertrophic scars, which stay within the boundaries of the original wound and may lessen with time. Keloid scars are not only cosmetically deforming, but can also cause physical symptoms such as pain, burning and itchiness.
Keloids can range in size from small to a size so large they can inhibit movement or range of motion. Keloids may continue to grow slowly for weeks, months or years. They eventually stop growing but do not disappear on their own. Once a keloid develops, it is permanent unless removed or treated successfully. Although keloids typically do not require medical attention, you may want to contact your doctor if growth continues, or if you develop additional symptoms.
A keloid may be:
- Flesh-colored, red or pink
- Lumpy (noduar) or ridged
- Irritated from friction such as rubbing on clothing
- Located over the site of a wound or injury
- Tender and itchy
What causes Keloid Scarring?
Keloids can occur after a trauma to the skin or surgery. Possible causes include acne scars, burns, chickenpox scars, ear piercing, scratches, surgical cuts and vaccination sites. Although an exact cause has not been identified, there is a strong genetic predisposition for keloids, with a higher prevalence in patients with darker skin tones. It is also known that genetic factors play a role in who is more likely to get these types of scars.
What are the conservative treatment options?
Conservative management includes pressure garments, silicone sheeting, steroid injections, as well as laser treatments. Unfortunately, recurrence rates are often high and surgical intervention may be necessary for the best results. Conservative treatments can be used as an initial treatment or in conjunction with surgical techniques.
What are the surgical options?
Treatment depends on many factors, including the size, location and depth of the keloid, your age, and which treatments, if any, have been previously tried. Possible surgical options include excision of the scar with closure. At The Institute for Advanced Reconstruction, we treat keloids in a multi-modal approach involving a Plastic Surgeon as well as a Radiation Oncologist to give the greatest result. Together, we determine the optimum course of treatment for an individual, on a case-by-case basis—so those who suffer now have a place to turn to for a solution. Patients are treated by surgical excision as well as a steroid injection at the time of surgery, followed by a dose of radiation to the site within 24 hours. This approach allows us to provide a long lasting result with the lowest recurrence rate.
How much radiation will I need and is it safe?
The radiation dose used is low and treatment sessions are usually being performed in one session. The dose of radiation is safe and has not shown to have any malignant potential. Additionally, precautions are made to shield non-affected areas of the body during the treatment.
What does the procedure entail and what is the recovery?
Excision of keloids is usually performed as an outpatient procedure, allowing patients to return home the same day. Patients are asked to limit any heavy lifting or strenuous exercise, and in most cases can return to work the next day. Patients will return for a follow up appointment within one week of their procedure.