Combined Keloid Removal Treatments

Dear Doc,

I am a 29 year old female, who has suffered from keloids since I was young. I have had a sternal keloid since I had chicken pox, 20 years ago. It has grown over the years and is now approximately 5 inches in width and 2 inches in length.

I have been undergoing a combination treatment of Kenalog & Botox injections, followed by Pulsed Dye Laser. The results have been promising, but slow. I was wondering if you could advise me, the interval that should be kept between the treatment sessions? Initially my doctor in Dubai maintained a 6 weeks gap, alternating between the injections and laser, but we realized that within 3 to 4 weeks, the keloid begins to hurt, become red again and grow.

So now we are maintaining a 3-4 week gap (i.e. steroid and Botox injections now and then 3 weeks later, pulsed dye laser, and then 3 weeks later the set of injections again.) Do you think the regiment we are following is suitable? Also, Botox is quite expensive, are the results really worth the cost? And is there anything more I can do to hasten the process. Thank you for your time.

Doctor Answers 2

Combined Keloid Removal Treatments

Hi Sapna,

Keloids are very difficult to treat no matter which protocol is used. Some treatments include steroid injections, cryotherapy and pulse dye laser . Although I have to admit I have never heard or botox treatments for Keloids.

I perform many keloid excisions and the best outcomes include surgery plus low dose radiation therapy over the course of 3 days. Even with this regimen, keloids can recur up to 30 % of the time.

Consider surgery with radiation. See my website results below.


New York Facial Plastic Surgeon
4.8 out of 5 stars 272 reviews

Injection vs. Botox vs. Topical Creams vs. Surgery

Keloid treatment should initially be conservative but should focus on definitive treatments and a goal of recurrence reduction. I have taken care of several patients from Gulf states, including Dubai and Saudi Arabia, who have had sternal keloids that are resistant to typical courses of steroids.

In these patients, I have focused on a multidisciplinary course of treatment including topical treatments, silicone sheeting, aggressive TAC injections, and surgery. This protocol should only be performed with physicians or surgeons who are experienced in aggressive keloid management for resistant scars. I also reserve such treatment for keloids in the proliferative phase of growth.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.