

Paul is seeing more and more keloid scars in the clinic.
Keloid scars are firm, raised overgrowths of scar tissue that extend beyond the original injury. They form when the skin produces too much collagen during healing, causing the scar to become larger, thicker, and often shiny or smooth. Keloids may feel itchy, tender, or tight while growing and can appear after cuts, burns, acne, piercings, or surgery. They’re more common on the chest, shoulders, back, jawline, and ears, and tend to occur more often in people with darker skin to
There is no single treatment for keloids, and most treatments do not give completely satisfying results. Two or more treatments may be combined. If you decide to pursue treatment for a keloid scar, you will have the best results if you start treatment soon after the keloid appears. Available treatments include: 1. Removal with conventional surgery — This unreliable technique requires great care, and keloids that return after being removed may be larger than the original. Keloids return in more than 45% of people when they are removed surgically. Keloids are less likely to return if surgical removal is combined with other treatments; 2. Dressings — Moist wound coverings made of silicone gel sheets have been shown in studies to sometimes reduce the size of keloids over time. This treatment is safe and painless; 3. Corticosteroid injections — Injections into keloids with triamcinolone acetonide or another corticosteroid medicine typically are repeated at intervals of four to six weeks. This treatment can often reduce keloid size and irritation, but injections are uncomfortable; 4. Compression — This involves using a bandage or tape to apply continuous pressure 24 hours a day for a period of six to 12 months. Such compression can cause a keloid to become smaller. For keloids that form at the site of an ear piercing, a clip known as a “Zimmer splint” usually reduces keloid size by at least 50% after one year of compression. Zimmer splints that resemble earrings are available; 5. Laser therapy — This is an alternative to conventional surgery for keloid removal. There is no good evidence that keloids are less likely to return after laser therapy than after regular surgery; 6. Fluorouracil injections — Injections into the keloids with the combination of the chemotherapy drug fluorouracil and triamcinolone have been used when other measures have not been successful.