Meshkinpour et al (2005) examined the safety and effectiveness of the ThermaCool TC radiofrequency system for treatment of hypertrophic and keloid scars and assessed treatment associated collagen changes. Six subjects with hypertrophic and 4 with keloid scars were treated with the ThermaCool device: 1/3 of the scar received no treatment (control), 1/3 received one treatment and 1/3 received 2 treatments (4-week interval). Scars were graded before and then 12 and 24 weeks after treatment on symptoms, pigmentation, vascularity, pliability, and height. Biopsies were taken from 4 subjects with hypertrophic scars and evaluated with hematoxylin and eosin (H & E) staining, multi-photon microscopy, and pro-collagen I and III immunohistochemistry. No adverse treatment effects occurred. Clinical and H & E evaluation revealed no significant differences between control and treatment sites. Differences in collagen morphology were detected in some subjects. Increased collagen production (type III > type I) was observed, appeared to peak between 6 and 10 weeks post-treatment and had not returned to baseline even after 12 weeks. The authors concluded that use of the thermage radiofrequency device on hypertrophic scars resulted in collagen fibril morphology and production changes. ThermaCool alone did not achieve clinical hypertrophic scar or keloid improvement. They noted that the collagen effects of this device should be studied further to optimize its therapeutic potential for all indications.
What to expect if you receive steroid injections : Immediately after each injection, the keloid becomes really swollen and discolored, and it actually looks much worse. Then, over the next few weeks, the steroid thins out the skin, the keloid flattens, and the color looks more normal.
Laser treatments : I underwent 3 or 4 laser treatments, but I did not see any significant improvements in color. My dermatologist said that laser treatment helps with color in about half of keloid patients. Although laser didn’t work for me, the color of the keloid has improved on its own with time.
When all other options have been exhausted, surgery and surgical intervention may be considered for treatment of your keloids. Dr. Behroozan has extensive surgical experience, and especially given his expertise as a Mohs Skin Cancer specialist, he has the ability to help you with your surgical evaluation and preparation for excision and reconstruction following removal of your keloid. It should always be remembered that keloids can recur following surgical intervention, and unfortunately, it is impossible to predict if this will happen. Be sure to discuss this with Dr. Behroozan prior to surgery. Recently, a FDA approved medication called imiquimod (Aldara) has been shown to possibly decrease the risks of keloid recurrence following excision. Dr. Behroozan may prescribe this medication to you following surgery as well as the use of silicone pressure earrings if your keloid is on your ear.