Head and Neck Surgery

Treatment of Keloids

Individuals prone to keloids can suffer severely disfiguring scars from a variety of different types of skin injury and sometimes from innocuous appearing skin insults such as acne or ear piercing. Common sites are the earlobes, upper trunk and extremities.

Excision followed by intralesional corticosteriod injections has been a standard treatment. In a retrospective study, Berman and Flores, from the University of Miami School of Medicine, compared injections of triamcinolone acetonide (TAC) or interferon-(2b (INF-(2b) to no adjunctive injection therapy after excision of 124 keloids, assessing whether post-excisional treatment actually reduces recurrence. Patients were observed for periods as long as 47 months after surgery.

Of the 43 keloids excised without postexcisional adjuvant treatment, 22 (51.2%) recurred compared with 38 (58.5%) of 65 after TAC treatment, demonstrating no benefit from postexcisional adjuvant TAC injections over excision alone. However, only 3 (18.7%) of 16 keloids recurred after INF-(2b. Recurrence rates did not differ based on keloid size, location nor TAC concentrations (10-20mg/cc or more).

In addition, patients with multiple keloids did not have a higher rate of recurrence than patients with a single keloid. The authors concluded that postexcisional TAC injections had no effect on recurrence of keloids. However, INF-(2b postexcisional adjuvant injections had a definite advantage over excision alone.

	Scaring Information Treatment of Keloids Individuals prone to keloids can suffer severely disfiguring scars from a variety of different types of skin injury and sometimes from innocuous appearing skin insults such as acne or ear piercing. Common sites are the earlobes, upper trunk and extremities. Excision followed by intralesional corticosteriod injections has been a standard treatment. In a retrospective study, Berman and Flores, from the University of Miami School of Medicine, compared injections of triamcinolone acetonide (TAC) or interferon-(2b (INF-(2b) to no adjunctive injection therapy after excision of 124 keloids, assessing whether post-excisional treatment actually reduces recurrence. Patients were observed for periods as long as 47 months after surgery. Of the 43 keloids excised without postexcisional adjuvant treatment, 22 (51.2%) recurred compared with 38 (58.5%) of 65 after TAC treatment, demonstrating no benefit from postexcisional adjuvant TAC injections over excision alone. However, only 3 (18.7%) of 16 keloids recurred after INF-(2b. Recurrence rates did not differ based on keloid size, location nor TAC concentrations (10-20mg/cc or more). In addition, patients with multiple keloids did not have a higher rate of recurrence than patients with a single keloid. The authors concluded that postexcisional TAC injections had no effect on recurrence of keloids. However, INF-(2b postexcisional adjuvant injections had a definite advantage over excision alone.