Keloid is Exuberant Scar Tissue
Keloid is exuberant scar tissue that goes beyond the original border of surgery or trauma. Hypertrophic scar is excess scar tissue that stays within periphery of original scar. Prevention is obviously preferable to treatment and any fresh scar incurred should prompt consultation with a board-certified dermatologist. Sun protection and scar massage may be important for the first couple months of a new scar. Application of silicone gel or sheeting can be quite helpful for a relatively new scar.
Intralesional steroid injection is the tried and true medical therapy for keloid or hypertrophic scar. A board-certified dermatologist may utilize intralesional steroid injection of varying strength and repeat injection as necessary every 4-8 weeks. There may be some risks of skin atrophy, pigmentary changes, and development of networks of fine blood vessels of surrounding areas where intralesional steroid is injected. Intralesional steroid injection of symptomatic keloid or hypertrophic scar is typically covered by most PPO insurance carriers and Medicare. Application of prescription-strength potent topical steroid, imiquimod and/or topical 5-fluorouracil may be considered. Radiation therapy should be considered as the very last resort given its potential morbidity and risk of future malignancy of tissue and organs near the treated area.
SRT-100TM or Superficial Radiotherapy is approved by the FDA for treatment of keloid and offers a revolutionary new modality to treat the toughest keloid. Dr. Ting is among the first dermatologists in California and West Coast to administer this state-of-the-art technology to treat resistant keloids. Success rate for keloid treatment will be higher if SRT-100TM treatment is preceded by excisional or shave removal of the keloid tissue prior to Superficial Radiotherapy. The side effects mostly involve pigmentary changes in treated areas. The This procedure may be covered by most PPO insurance carriers.Cryoshape is FDA-approved for resistant keloids with 93% success rate. Dr. Ting is among the first in Bay Area to offer this revolutionary modality utilizing liquid nitrogen delivered via a special probe that gets inserted inside keloid to achieve controlled necrosis of keloid tissue. This procedure is not covered by any insurance carriers. There may be risk of loss of pigmentation among ethnic skin and Cryoshape does not work as well in a skin area that has been previously treated with radiation therapy.
GenesisPlus Advanced Laser Therapy for Hypertrophic Scar
is an innovative modality to treat and accelerate scar remodeling, minimize redness associated with scar and enhance cosmesis. GenesisPlus also softens and relaxes the tension in scars, improving mobility for the patient. Dr. Ting recommends a series of 4 GenesisPlus Advanced Laser Therapy for hypertrophic scar, sometimes in combination with intralesional steroid injection.