What are alternative ways to remove a long keloid scar if multiple steroid injections did not work?

Doctor's Answers 1

Hi,

A keloid scar, short or long, cannot be totally removed. It can only be improved upon.

If multiple steroid injections "did not work", other options to consider may include:

  1. Increasing the potency of the injected steroids i.e. use a higher concentration. While more effective, potential side-effects such as skin atrophy, telangiectasias, discoloration may be more frequent and severe.

  2. Use a combination of steroid mixed with 5-Fluorouracil. 5-Fluorouracil is an anti-cancer drug. This combination is reported to be more effective than steroid alone.

  3. Add laser to augment improvement. The pulse-dye vascular laser (595nm) and high energy drilling fractional CO2 laser are effective.

Whatever therapies are used, recurrences are to be expected.

Surgical excision is often associated with recurrences which may be worse compared to the original scar and should be undertaken as a last resort after a thorough discussion with an experienced surgeon. DXT post-surgery may help reduce keloid recurrence post-surgery.

Similar Questions

How painful is keloid scar treatment?

Thanks for the question. I do agree with the answers posted by Dr Winston and Dr Ethan that intra-lesional steroid injections (injecting directly into the keloid) would be the most suitable treatment to reduce the size and thickness of the keloid. Several monthly injections will be needed. The initial injections may be a little more painful but the pain is usually better with subsequent injections. There will be some pain with the injection but this is usually bearable. If you are really afraid of the pain, applying some numbing cream prior to the injection may help.

Photo of Dr Colin Theng

Answered By

Dr Colin Theng

Dermatologist

How can one treat keloid scars that recur after steroid injections?

Keloids present as red raised scars and are often treated with steroid injections to flatten these scars. Combination treatment with the VBEAM laser and steroid injections can also be used and such combination treatments are found to be better at flattening and lightening these raised scars. Usually 4-5 monthly treatments are advised and most patients will see excellent results. For some patients who are prone to recurrence, 3 monthly maintenance treatment may be required. The cost depends on the number of scars we are treating, and can vary from $400-800 usually. Hope this helps!

Photo of Dr Stephanie  Ho

Answered By

Dr Stephanie Ho

Dermatologist

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