Keloid Scars of the Face and Neck
Cosmetic facial surgeons frequently see patients with keloid scars. There are many types of scars. Hypertrophic scars are those which enlarge within the boundaries of the original scar and keloid scars are those that enlarge outside the boundary of the original scar. Due to this, keloids can become quite large and disfiguring. Although any race can develop keloids, they are most common in darker skin types. The actual cause of keloids remains unknown but they frequently develop as a response to irritation, such as ear piercings, traumatic lacerations or surgical incisions. Some areas of the body are notorious for forming keloids such as the earlobes or the sternum (breast bone) in open heart surgery incisions.
Over the years there have been many different treatments for keloid scars. Although it is tempting to merely excise them, they will most often return with a vengeance, growing larger than the original keloid.
One of the most simple and frequently effective treatments for keloids is injection with an anti inflammatory steroid such as Kenalog (triamcinalone). This causes the keloid to shrink and repeated injections can be quite effective in softening and reducing the size of the keloid. A chemotherapy drug called 5 flourouracil can also be mixed with the Kenalog for even more scar dissolving power. Sometimes injectable steroids are quite effective and can dissolve the entire keloid.
The patient above was treated with Kenalog injection only.
Another method of treating keloids is to surgically excise the keloid and begin immediate injection of Kenalog. I have used this technique on smaller keloids with good success.
The most effective method for treating larger keloids is to surgically excise the keloid, then proceed immediately to the hospital for a single radiation to the area. This has been my most successful treatment for very large keloids. Although it is impossible to guarantee the the keloid will not reoccur, the combination of surgical excision and single dose radiation has been a very positive treatment in my practice.
The above keloids was treated with surgical incision and immediate single dose radiation. This treatment is frequently covered by insurance.
For more information on the cosmetic treatment of head and neck scars and other cosmetic facial surgery procedures, see
Joe Niamtu, III DMD
Cosmetic Facial Surgery
Richmond, VIrginia
