Hi! I'm a 22-year-old African American male. I have two small hypertrophic scars on my jawline from acne. I've had them for at least 3 years and have been getting them injected for at least a year and a half. I'll be graduating from college in 2 weeks and I just want to start anew. Would excision with cortisone injection followed by aldara cream be reasonable? How much would it cost? I've had my ears pierce 4 times with one getting infected with no keloid, and all the cuts and scraps i received as a kid never keloided.
Facial Hypertrophic Acne Scar Excision with Aldara?
Doctor Answers 4
Aldara and keloids
We have had some good results with Aldara topically combined with cortisone injection of keloids. Surgical excision runs the risk of creating even bigger keloids. Give the more gentle approach a chance. Aldara can be irritating so discontinue for a few days if irritation occurs.
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Facial hypertrophic scar excision
I consider excision of hypertrophic scars/keloids to be a last resort, particularly on the face - you may have reached that point. You simply need to be aware that even with Aldara, there is a considerable recurrence risk. If you were my patient, I would suggest first trying up to 40 mg/mL of Kenalog for injection as well as inject 5-Fluorouracil before resorting to surgery.
Certainly, steroid injections would be first-line treatment. However, if these were not effective. I concur that this would be an acceptable avenue to try. Keloids are rare on the face.
The combination of aldara and steroid injections should help prevent recurrence. Just be compliant with this treatment plan. I would also choose someone skilled in this type of surgery.
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Keloid treatment on the face, chin, neck
Keloids commonly occur on dynamic areas of the face such as the jawline, neck, and posterior scalp. Patients should be cautious of the long term recurrence rate and the risk for further exacerbation of the keloids with surgery. I would suggest a continued course of 5-FU or Kenalog injection before initiating surgical treatment.