Keloid steroid injection dose

It’s been 9 days since my last post, and the top layer of my hypertrophic scar is still gone. I probably exfoliated too much because a new scab isn’t forming. I decided that I should leave it alone for a while because the open wound is a little unsettling for me. For now, I keep it covered with neosporin and a band-aid. I have Scar Away silicone patches for when it closes. In addition, the bruised area surrounding my hypertrophic scar caused by the ACV irritation has given way to a new problem… that area of my skin began to scab.

Steroids have been long used in treatment of various skin disorders. Injecting steroids directly inside the keloid tissue, known as intra-lesional injection, is a commonly used method of treating small keloids. This treatment however, is only partially effective. Triamcinolone acetonide is the most commonly used drug for treatment of keloids. Dr. Sexton reported the efficacy of intra-dermal injection of this fluorinated prednisolone derivative in 1960 . Applied intralesionally, triamcinolone acetonide is one of the most widely used treatments for keloids, whether alone or in combination with another type of treatment. Steroid injections are not as effective as we would like them to be. About one third of patients give up treatment because of intense pain. About 15% of patients report worsening of their keloids following steroid injections.

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.

As previously indicated, it is imperative for the head and neck surgeon to properly identify the type of scar as a wound contracture, hypertrophic scar, or keloid as this information will dictate the most effective form of treatment. A scar contracture can be identified by its re­strictive nature as well as its confinement to the area of trauma and its lack of fibrous tissue outgrowths. Keloids and HTSs, on the otherhand, all have some degree of fi­brous outgrowth. HTSs remain with the confines of the wound and typically decrease in size over time as op-posed to keloids, which may have phases of quiescence followed by reactivation and enlargement.

Keloid steroid injection dose

keloid steroid injection dose

As previously indicated, it is imperative for the head and neck surgeon to properly identify the type of scar as a wound contracture, hypertrophic scar, or keloid as this information will dictate the most effective form of treatment. A scar contracture can be identified by its re­strictive nature as well as its confinement to the area of trauma and its lack of fibrous tissue outgrowths. Keloids and HTSs, on the otherhand, all have some degree of fi­brous outgrowth. HTSs remain with the confines of the wound and typically decrease in size over time as op-posed to keloids, which may have phases of quiescence followed by reactivation and enlargement.

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