Asian female with keloid scars on shoulders and chest from accident 10 years ago, what can help? (photos)

Question

Does anyone specialize in this? My girlfriend has a large keloid on her chest and one on each shoulder from an accident 10 years ago. She is Asian. We heard that Cryotherapy may work. She feels disfigured and ashamed.

Jason Emer, MD · Answer

I agree with below, I have never seen great success with just steroid injection alone.  I think excision +/- followed by one dose of radiation and steroid injections and topical creams or laser treatments are needed.  there is nothing that can get rid of this completely without any evidence or any treatments that will completely prevent recurrence.  Removal requires a process and most of the treatments will not be covered by insurance.  Sometimes the injections require the addition of a medication called 5-FU into the steroid.  The point is, there are many options, not one is the best but you will need a combination of therapies to help get you to the best result.  I wish you the best, Dr. Emer.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Harold J. Kaplan, MD · Answer

Hi CH.  The most commonly used treatment for the treatment of keloids is steroid injections.  We have treated many of the size shown effectively with this method.  We use Kenalog and believe it to be one of the most effective options.  The drug used, concentration chosen and injection technique will all affect outcome so even if you have tried this method, it's still the most common and most effective.  After the scars have been flattened, we use pulsed dye lasers to remove some or all of the redness.  Check the link below for a similar case.

Robert Whitfield, MD · Answer

The scar would require excision, steroid injection and then use of the product Embrace.  Embrace is only available to Plastic Surgeons in the United States.

Asian female with keloid scars on shoulders and chest from accident 10 years ago, what can help? (photos)

Answers (4)

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