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Keloids are an unsightly, elevated type of scar composed of excessive collagen. They present as firm, rubbery lesions, and can vary from pink to dark brown in color. Although they usually occur at the site of an injury, keloids can also arise spontaneously. Keloid scars are benign, however they can sometimes be accompanied by severe itchiness, pain and changes of texture. In severe cases, they may even impair movement. 

Keloids are an unsightly, elevated type of scar composed of excessive collagen.

They present as firm, rubbery lesions, and can vary from pink to dark brown in color. Although they usually occur at the site of an injury, keloids can also arise spontaneously.

Keloid scars are benign, however they can sometimes be accompanied by severe itchiness, pain and changes of texture. In severe cases, they may even impair movement.

How can it be treated?

The best treatment is prevention for individuals with a family history of keloids. Various therapies can be administered such as laser, cryosurgery, topical agent, external bean radiotherapy or surgical excision. Surgical excision is currently the most favored treatment. However, it carries a recurrence rate of 70-100%.

In a clinic setting, one of the easiest and most tolerable forms of treatment is intralesional injection of corticosteroids namely triamcinolone. They are widely considered as the first-line therapy for most physicians.

How is this procedure done?

Triamcinolone is often combined with lidocaine (50:50 ratio) to minimize pain and injected into the lesion. Usually, 3-4 injections are given a month apart although the therapy can be continue for 6 months or longer if the lesions are large. This eventually flattens the keloid by 50-100% with a 9-50% recurrence rate.

Are there any side effects?

Like any injection, there may be some associated redness and swelling but this resolves within a few days. Note that while the injections may flatten the scar, it does not lighten the color and laser would be required for that.

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