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Steroids are injected straight into the scar tissue to help decrease itching, redness, and general discomfort. Some doctors note that the treatment of these symptoms with steroidal injections can also reduce the appearance of scars. Steroid injections (triamcinolone) are given every two to six weeks until improvement is seen. Occasionally, injections can cause a network of surface veins to develop (telangiectasias), or lightening or thinning of the surrounding skin. Research has shown that cryotherapy can decrease the thickness of the scar tissue by up to 58%. The earlier the treatment and thinner the keloid scar, the better the results. Cryotherapy is performed in the physician office using medical instruments that instantly freeze the tissue and kill it on contact. Cryotherapy can cause burns, more scar formation and damage to nearby healthy tissue if done improperly. When cryotherapy is used to treat keloid tissue, further preventative methods must be used as the area heals, such as silicone dioxide, silicone gel sheets and steroid injections. Another option for reducing the appearance of keloid scars is radiation therapy. Some plastic surgeons avoid this method of scar removal due to concerns about causing tumors, but studies have shown that this is a safe method as long as surrounding tissues are protected. By itself, surgery can often cause further aggravation and create more scars, but if performed in combination with a number of other treatments (e.g. silicone sheeting and silicone dioxide), surgery can reduce the visibility of such scarring. Once the surgical excision has healed, discuss the use of silicone gel sheets to reduce the recurrence of the scar formation. If you decide to go the surgical route, ask your doctor about Imiquimod. It is a cream that enhances healing and is often used after surgery to prevent scarring. The cream is applied on alternate nights for eight weeks after surgery. Although the trials have been small, the post-surgical recurrence rate averaged only 28 percent over a six- to nine-month follow-up period, with best results (2.9 percent recurrence) in low skin tension areas such as earlobes.
Ask your doctor about steroid injections. Try cryotherapy. Ask about radiation therapy. Discuss surgical excision with your doctor.