Chest Keloids Kenalog Injections. Any suggestions?

Question

I'm a 21 y/o M who has suffered from chest keloids since age 14 (due to acne). For the past 2 years I've been receiving kenalog injections approx. every month with pretty great results (flattening, less red, less pain etc.). However, I notice that towards the end of the month some regression occurs and the pain returns hence my need to continue with injections. My question is in regards to the efficacy of long term kenalog injections. Do they become less efficacious over time? Are they safe?

Jason Emer, MD · Answer

I would suggest an in person consultation with an expert for evaluation. Keloids and hypertrophic scarring should be treated in a combination approach with lasers along with steroid/5fu injections. Best, Dr. Emer.

Raffy Karamanoukian, MD, FACS · Answer

I would opt for a more targetted approach with lasers, injections, and topical therapy. Apply Plato's Scar Serum twice daily and discuss ancillary procedures with your surgeon. Best, Dr. KaramanoukianLos Angeles

Amy Forman Taub, MD · Answer

First of all, the approach you are taking is the one universally applied for keloids as a first line therapy.  One thing  you could ask your doctor is what the concentration is of the cortisone he/she is injecting.  Sometimes increasing the strength of the cortisone will result in a longer lasting treatment.  Increasing the dose of the steroid can have more side effects such as skin atrophy or dilated blood vessels.  Also, this is a potential side effect of repeated injections.  The addition of 5-fluoruracil to the steroid injection or using it alone can sometimes help with the keloid and reduce the potential for atrophy.  This is an anti-cancer drug that works by impairing the cells ability to function.  In the doses required in the skin for scarring there haven't been reports of problems with 5FU.  A triple combination has been found to work recently as well: steroid, 5-FU and hyaluronidase.  Hyaluronidase is an enzyme that breaks down hyaluronic acid, a component of skin and is believed to help the steroid and 5FU penetrate throughout the scar.  Finally more recent work uses very low density carbon dioxide laser in combination with topical or injected cortisone and 5FU.  I have found this approach to be effective but it take many, many treatments and much patience.

Chest Keloids Kenalog Injections. Any suggestions?

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Chest Keloids Kenalog Injections. Any suggestions?

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