My 8 year old had large keloid removed from chest. I had steroid injections stopped because it was too traumatic for a child. Now the scar/keloid is 3x bigger. We have tried silicone gel patches, silicone creams, etc. Keloid still growing. HELP!
Help for Recurring and Growing Chest Keloid on an 8 Year Old?
Doctor Answers 2
Keloids scar treatment for active scars
I have extensive experience in keloid treatment and believe that combination treatments with IIT, cryotherapy, surgical excision, and pressure work best when used in combination. Children do well with laser treatments for active keloids.
Treatment of keloids on the chest
The treatment of keloids is surgical removal followed by
1. wearing of a pressure garment & scar injections with weekly office visits for 2 to 3 months
2. a total of 4 radiation treatments to the area starting the day after the removal & completed within 1 week of surgery (performed mostly on out of town patients & those who cannot fill the requirements of option 1)
In my experience all other treatments are accompanied by a very high recurrence rate. If the keloid comes back it is harder to treat the 2nd, 3rd time etc.
The shoulder & central chest areas are probably the most difficult to treat. There tends to be little excess skin to allow closure without tension after keloid removal. So in most cases, the keloid has to be debulked using the skin on top of it to allow closure without tension. If you just cut it out you cannot close the resulting wound. The skin hangs over the shoulders the way a shirt hangs on a hanger so there is constant tension along the scar line. The skin is thicker in these areas than most other areas of the body. It is very difficult to get adequate compression over these areas with a compression garment. The garment has to cover the both shoulders to get any compression & even then is not optimal.
I have treated central chest keloids with significant improvement. The problem is an 8 year old is too young to have option 2. For option one with a chest keloid your best bet for a pressure garment is a custom made one with a silicone patch directly over the surgical site. As for injections in an 8 year old, a needleless pressure injector (madajet) should be used. For adults this is usual done under local anesthetic depending on the size of the keloid but a child is better off getting anesthesia from an anesthesiologist.