What can I do to get rid of my keloids in the back of my head and on top? It itches

It is always a good idea to get a diagnosis from a qualified specialist. There are several different conditions, ranging from harmless to life-threatening, that may manifest symptoms such as itchy keloids on the back of the head. Acne Keloidalis Nuchae (AKN) is an often overlooked condition of folliculitis which can be overlooked in this regard. It starts out as small pimple like bumps which later fuse together into a larger mass that resembles a keloid. Itching is also a common symptom due to the discharge from the sebaceous glands which attracts bacteria. Although prescription medications can help alleviate discomfort, they won’t get rid of the tissue growth. Surgical excision is the only reliable way to eliminate it altogether.I have provided a link below with a patient example of this condition and the results of surgical treatment.

Our office specializes in keloid therapy. I would start with Plato's Scar Serum, followed by IIT Kenalog, lasers, and massage therapy. Best, Dr. KaramanoukianLos Angeles

A combination approach is needed. Injectable steroids with or without 5-FU, lasers, and microneedling/prp may help to give improvement. Surgery with or without radiation is an alternative. I recommend getting a formal evaluation with a scarring expert. Best, Dr. Emer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Some patients benefit from excision of keloids.   Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their
results.   The most important aspect is to find a surgeon you are
comfortable with. I recommend that you seek consultation with a qualified
board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Thank you for your question. It is best to get an in-person evaluation to determine the best treatment for your specific case.  I have successfully treated keloids in my office and tend to favor the less-invasive procedures to mitigate the risk of developing other keloids.  Unfortunately, there is no cure for these lesions. If you are prone, you must be careful with your skin for the remainder of your life. Initial methods of treatment involve injecting a corticosteroid called kenalog (5-40mg per ml) to reduce the size of the keloid. For larger more persistent keloids, I inject Kenalog mixed with a very effective cutaneous chemotherapy drug called fluorouacil (5FU). 5FU is a medication that is used to shrink tumors, eradicate precancerous lesions and skin cancers. It has also been a remarkable medication when injected directly into a keloid. Treatment options for thickened, red and more hypertrophic scars include using a vascular laser to flatten the scar and remove the redness. These treatment options can take 5-10 sessions, spaced over 4 weeks apart.

Keloids can sometimes be surgically excised but there is a risk for developing an additional larger keloid. However, surgical removal on the ear lobe is an excellent method in treating and eradicating keloids.Best,Ariel Ostad MD PC 

An assessment is needed. You have conservative choices, - Steroid injections, 5 FU combination Botox to relax the myofibrils, and laser with fractional C02 or Mironeedling with drip ILCS. The other option is surgical, however this is best combined with radiotherapy. The best method is an individual based assessment- we take into consideration your age, the extent and area of keloids and your expectations. All the best, Dr Davin S. Lim. Brisbane. Australia.