Dear Doctor
I have what I think was a burn from hair removal cream years ago.
It was find and would occasionally itch but no thought of it.
Now it is really bad, dries out and itches daily and when I scratch it, it becomes red and inflamed like the picture.
Can you suggest any creams to go on it?
Dear Patient
Your symptoms are suggestive of a keloid.
Burns like the one you sustained often heal with keloids.
Other common causes of keloids include acne, chickenpox, accidental injuries and surgical operations.
Keloid Treatment
The treatment of keloids includes the use of:
1. Silicone gel
Silicone gels like ScarAway have been shown to be safe and effective treatment for keloids.
2. Corticosteroid Injections
Injections of Triamcinolone Acetonide (Kenalog) are used for keloid treatment. This corticosteroid is injected several times every 4-6 weeks. Adverse effects include hypopigmentation (skin lightening) and atrophy (skin thinning).
3. Surgical removal
Keloidectomy or the surgical removal of keloids is another way of treating them. Unfortunately, it has a recurrence rate of around 50%.
This high recurrence rate can be reduced by combining keloidectomy with monthly steroid injections or radiotherapy.
4. Interferon alfa-2b
Inerferon alfa-2b has been used to reduce keloid scars that were not responding to intralesional steroids. They are also used to prevent keloid recurrences after surgical removal.
5. Imiquimod
Imiquimod 5% cream was shown in a study to prevent keloid recurrences when it was used for 8 weeks. However it can cause hyperpigmentation (skin darkening).
Keloids are quite challenging to treat and I recommend that you discuss your options with your Plastic Surgeon.
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