is my scar a keloid/hypertrophic scar? What alternative treatments can I try? It's a scar left from birthmark removal (Photo)

I am getting steroid injections monthly combined with laser; the scar flattens but within 2-3 weeks the scar tissue reforms again. I just started applying a topical that has steroids too. i am not sure whether my scar is considered to be Keloid or hyoerophic scar? few options were give to me skin grafting or revision surgery? Are there any other less invasive treatments i should consider? Other types of laser such as fraxel; or Erbuim? or even dermabrasion? Help.

Doctor Answers 4

Keloid scar from birthmark removal

This is a keloid scar on your chest; it is red and swollen, and likely itchy. Your best treatment option is intralesional steroid/kenalog, best preceded by liquid nitrogen application. Once flattened, any remaining redness or skin uneveness can be treated with laser. Best to speak with your dermatologist, experts in managing keloids.

Toronto Dermatologic Surgeon
4.8 out of 5 stars 53 reviews

Treatment for Keloid Scar

Hi Susua.  It looks like a keloid.  To know whether we agree with your plan, we would need to know what laser is being used.  The only laser we would use on that type of scar is a pulsed dye laser (for redness) and in most cases we would not use that laser until the scar has been flattened completely.  

If the scar is flattening and then returning, it's very possible that the regeneration of the scar is related to the trauma of the laser treatment, especially if this is a fractional resurfacing.  

If steroids are working to flatten (we use Kenalog), then stick with those only for now and consider a pulsed dye laser for any residual redness at the end of the steroid injections.  

Take a look at the before and after picture at the link below to see what steroids can do.  

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Keloid Treatment Options

Seek a cosmetic dermatologist with expertise in lasers and scar treatments. This is a keloid that will require a series of treatments of injections and lasers.  Even with the appropriate options, you may not get the best results.  I typically do a combination of two lasers (Excel V and Fraxel) and then immediately inject or drip on liquid steroid.  Often, a series of smaller surgeries can be used in combination with either radiation or injectable steroid to prevent the keloids recurrence.  But again, this is a scar, that may be permanent despite what treatment options are given or tried.  Seek someone with experience for the best treatment outcome.  I wish you the best of luck, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 196 reviews

Keloid removal and Plato's Scar Serum

Our office specializes in keloid removal. Cortisone creams are not applicable in your case. We would begin with topical creams (Plato's Scar Serum), intralesional injections, and laser therapy. 

Raffy Karamanoukian MD FACS

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.