Knowing When to Consider Excision Surgery for Keloid Treatment

Keloids, raised scars that extend beyond the boundaries of the original wound, can be not only physically uncomfortable but also emotionally distressing for those affected. While there are various treatment options available, including conservative approaches such as steroid injections, laser therapy, pressure therapy and 5FU injections, excision surgery remains a viable option for keloid removal in certain cases. There are times when it may be appropriate to consider excision surgery for keloid treatment after attempting conservative measures.

Understanding Keloid Formation

Before delving into treatment options, it’s essential to understand how keloids form. Keloids develop when the body produces an excess amount of collagen in response to skin injury or trauma. This overproduction of collagen leads to the formation of raised, often painful scars that can be challenging to manage and treat effectively.

Conservative Treatments for Keloids

In many cases, conservative treatments are the first line of defense against keloids. These non-surgical approaches aim to reduce scar size, flatten the keloid, and alleviate associated symptoms such as itching and discomfort. Some of the conservative treatments commonly used for keloids include:

• Steroid Injections: Corticosteroid injections are often used to reduce inflammation and suppress collagen production in keloid scars. Multiple injections may be administered over several months to achieve the desired results.
• Laser Therapy: Laser treatment can help improve the appearance of keloid scars by targeting the excess collagen and promoting collagen remodeling. This approach may be particularly beneficial for keloids that are resistant to other forms of treatment.
• Pressure Therapy: Applying pressure to keloid scars using specialized dressings, silicone sheets or compression garments can help flatten the scar and reduce its size over time. Pressure therapy is most effective when used consistently and in conjunction with other treatment modalities.
• 5FU Injections: 5-fluorouracil (5FU) injections are a chemotherapy medication that has been shown to inhibit the growth of keloid scars by interfering with the production of DNA and RNA in keloid cells. These injections are typically administered in combination with corticosteroid injections for enhanced efficacy.

When to Consider Excision Surgery

While conservative treatments can be effective for many patients, there are instances where excision surgery may be warranted for keloid treatment. Excision surgery involves surgically removing the keloid scar and suturing the wound closed. Reconstruction techniques such as skin grafting or flap surgery may be used to minimize scarring and improve aesthetic outcomes.

Excision surgery may be considered in the following situations:

• Failure of Conservative Treatments: If conservative treatments fail to produce satisfactory results or if the keloid continues to grow despite treatment, excision surgery may be necessary to remove the scar tissue and prevent further complications.
• Large or Symptomatic Keloids: Keloids that are particularly large, painful, or causing functional impairment may benefit from surgical removal to alleviate symptoms and improve quality of life.
• Cosmetic Concerns: Keloids located in highly visible areas of the body can significantly impact a patient’s appearance and self-confidence, so excision surgery may be pursued to achieve a more aesthetically pleasing outcome.

While conservative treatments are often the first line of defense against keloids, excision surgery may be considered in cases where conservative measures fail to produce satisfactory results or when the keloid is large, symptomatic or cosmetically concerning. At the International Keloid & Scar Treatment Center, we specialize in the management of keloids and offer a comprehensive range of treatment options tailored to each patient’s unique situation. Contact us today to schedule a consultation and take the first step towards keloid-free skin.