Keloids are a type of excessive scar tissue that forms after the skin has been injured. They are characterized by raised and expanding scars that extend beyond the original wound area. Keloids can cause not only cosmetic concerns but also symptoms such as itching and pain, which can place a significant physical and psychological burden on patients. Keloids may develop after burns, surgeries, piercings, acne, and various other skin injuries. Genetic factors also play a role, making some people more prone to keloid formation than others.
Keloids are often confused with hypertrophic scars. Both present as raised, red scars, but hypertrophic scars remain confined to the original wound boundary, while keloids grow beyond it. Moreover, hypertrophic scars may improve naturally over time, whereas keloids rarely do, often requiring long-term treatment and monitoring.
There are several treatment options for keloids, but it is uncommon for a single therapy to completely cure them. Therefore, a combination of treatments tailored to the patient’s condition is usually recommended. Below are some common treatments:
One of the most fundamental treatment methods for keloids is the use of topical or injectable corticosteroids. Steroids work by suppressing inflammation and inhibiting cell proliferation, which helps to reduce the growth of keloid tissue.
In particular, Kenacort and other steroid injections are commonly used, as they allow the medication to act directly on the affected area. However, injections can be painful, which may cause discomfort for some patients.
In such cases, topical steroid patch formulations such as “Eclar Plaster” have attracted attention. Eclar Plaster contains the active ingredient prednisolone valerate acetate, and is formulated as a medicated adhesive tape. It is used to treat keloids and hypertrophic scars. When applied directly to the affected area, it delivers a sustained dose of the medication to help reduce inflammation, redness, and the raised appearance of the scar.
[ECLAR Plasters 20μg/cm2] Steroid tape for keloids, dermatitis “HISAMITSU”
Sheet: 1 box (50 sheets)
Pressure Therapy
Applying sustained pressure to the affected area reduces blood flow and prevents excessive scar tissue growth. For keloids on the earlobe, specialized pressure earrings are sometimes used. While pressure therapy requires long-term application, it generally has few side effects.
Silicone Gel Sheets
Silicone sheets are applied to the scar to prevent moisture loss from the skin, which can help reduce scar elevation and redness. These sheets are widely available and easy to use at home, making them a common adjunct treatment.
Oral Medication (Tranilast / Rizaben)
Keloid formation involves inflammatory cytokines and chemical mediators such as histamine. To suppress these factors, oral administration of Tranilast (marketed as Rizaben), an anti-allergic medication, is sometimes prescribed. Tranilast inhibits the release of chemical substances from mast cells and suppresses abnormal fibroblast proliferation and excessive collagen production. It is used to treat keloids and hypertrophic scars.
Tranilast generally has few side effects and is taken over several months to help prevent recurrence and formation of new keloids. However, individual responses vary, and the effects may not be immediately visible. Long-term use under physician supervision is recommended.
[RIZABEN 100mg] For allergies and keloids “KISSEI” Tranilast
RIZABEN is used to treat bronchial asthma, allergic rhinitis, atopic dermatitis, and keloids and hypertrophic scars.
[TRANILAST CAPSULES 100mg] To Allergic rhinitis, keloid “TOWA”
It is classified as a “chemical mediator release inhibitor” among anti-allergy drugs. It does not have the side effects of drowsiness and dry mouth seen with conventional antihistamines. It is indicated for keloids and hypertrophic scars.
Radiation Therapy
Radiation is used particularly for large keloids or cases with a high risk of recurrence after surgery. It suppresses cell proliferation and helps prevent regrowth. However, because there is a theoretical risk of cancer, radiation therapy must be carefully considered.
Surgical Treatment
Surgical removal of keloids is an option, but alone it carries a high risk of recurrence. Surgery is usually combined with radiation or steroid injections to improve outcomes. Surgery itself may trigger new keloid formation, so careful case selection is essential.
Other Treatments
Other approaches under study or in use include local injections of anti-cancer drugs like 5-fluorouracil (5-FU) or interferon, laser treatments, and traditional herbal medicines. These are still limited in clinical evidence and should be used under expert guidance.
Choosing Treatments and Lifestyle Considerations
Because keloid treatment often requires prolonged therapy, interruption can increase the risk of recurrence. Maintaining close communication with a trusted dermatologist or plastic surgeon is vital. Additionally, avoiding skin irritation, excessive sun exposure, and maintaining good skin hydration are important for preventing recurrence.
Stress and hormonal balance may also influence keloid formation, so a regular lifestyle and mental well-being are recommended. People prone to keloids should avoid unnecessary skin trauma such as surgery or piercings, or take preventive measures if such procedures are planned.
Summary
Keloids are more than just scars; they result from a complex interplay of genetic predisposition, lifestyle, and treatment choices. While complete cure can be difficult, early intervention and prevention are crucial. Advances in research have broadened treatment options, but personalized treatment tailored to each patient’s condition remains the standard. Those troubled by keloids are strongly advised to seek consultation with a specialist rather than self-managing.