What Can I Do About the Itching and Pain of the Keloids?

Question

I am a 65 year old African American male with a serious keloid problem. They are my neck, shoulder, chest, lower stomach area and left arm.

Raffy Karamanoukian, MD, FACS · Answer

Itching and pain most likey indicate that your keloid is in an active growth phase.  The first line of therapy in my office would include:

	 

	
		Pulsed Dye Scar Laser
	
		Selective IIT


	I would not recommend chemotherapy injections or radiation at this stage.

Brian S. Biesman, MD · Answer

Not all elevated, thickened scars are the same. Scars that grow beyond the borders of the initial injury (incsion, cut, etc) are referred to as keloids. They are not as common as hypertrophic scars but are more challenging to treat. Steroid injections can provide benefit but surgery followed by radiation is sometimes required as well. In contrast, hypertrophic scars are thickened, elevated scars that may be red in color or may be the color of your skin. Hypertrophic scars occur commonly when there is tension across wounds such as on shoulders, elbows, knees, etc. Hypertrophic scarring is also well recognized to occur from facelift incisions, and following breast or abdominal surgery. In contrast to keloids, hypertrophic scars tend to respond well to medical therapy such as steroid injection, laser treatment, and occlusion with silicone dressings. It is therefore important to make the distinction between hypertrophic scars and keloids.

Kenneth Dembny, II, MD · Answer

Keloids can be very difficult to manage. Steroid injections directly into the keloid can improve symptoms such as pain and itching; steroids may also soften the keloids. Some of the body areas you describe are notorious for less than optimal healing, and have a greater frequency of widened scars, thickened scars, and/or symptomatic scars. Keloids can be excised, sometimes with good results, but results do vary and good post-operative follow-up is needed. Consult a plastic surgeon in your area that can review the options listed above, and make realistic recommendations for your best treatment options.

	Best wishes, Ken Dembny

Benjamin Barankin, MD, FRCPC · Answer

The best way to minimize the symptoms of keloids such as itching, burning or pain is to inject them with either cortisone or 5-FU. Speak to your dermatologist about your best treatment options.

What Can I Do About the Itching and Pain of the Keloids?

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