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Dr Jennifer Crawley on the treatment of keloid scars at Clinica London

Keloid scars can be unsightly, tender and yet can be treated by a variety of means, including topical steroids, silicone gel and cream, and intralesional steroid injection
Dr Jennifer Crawley: Something that can be very troublesome for patients, that we can help with, are patients perhaps with lots of scarring on their skin namely keloid scarring.
Miss Jane Olver: Please tell me what you think about keloid scars. I always thought they only occurred in people of African origin. I understand a lot of more people can get keloid scars.
Dr Jennifer Crawley: Yes, absolutely Jane. They are more common, and the prevalence is higher in Asian and black skin type than in white skinned people, especially after trauma to the skin. But white skin people and patients with fairer complexion can get keloid scars also. They are generally due to trauma or acne on their skin, and they present as a raised thickened itchy scar on the skin.
Miss Jane Olver: Is that a tender scar or it is just a visible scar?
Dr Jennifer Crawley: So it is visible Jane but yes they can be very tender, very sensitive, and can cause problems with quite a lot of itching also.
Miss Jane Olver: Is that in the early stage or does that persist longer?
Dr Jennifer Crawley: That persists longer.
Miss Jane Olver: Really?
Dr Jennifer Crawley: Yes, absolutely and there are different things that we can do to treat those, for example, we can handle them with specialised topical therapies, but the mainstay of the treatment, that I do, that it is particularly helpful, is injecting the keloid scar with an intralesional steroid. Intralesional steroid can help settle down the fibrous tissue and the inflammation, not only to improve the cosmetic appearance of the scar but also to improve those symptoms of sensitivity and itching and discomfort.
Miss Jane Olver: Jennifer, with a keloid scar, is one injection enough or is it likely to need more?
Dr Jennifer Crawley: No, Jane, you definitely need a course of injections, so it is unlikely that you ever get to improve this scar with just one injection. Quite often you need a course of injections four weeks apart. Some scars that are small may need fewer treatments, however large or more thickened scars can need more treatments. It is challenging for me to advise on until I see and examine the scar and certainly until I do the first injection at least as different people respond to the injections in different ways. Some people will settle quite quickly, and some people may take a little bit longer than others, but that indeed is something that is easy for us to do here at Clinica.
Dr Jane Olver: What are the success rates in treating keloid scars with an intralesional steroid?
Miss Jennifer Crawley: So the success rates with the injections is excellent. Of all the treatments that we have for keloid scars, I am thinking about topical steroids, silicone gel and cream treatment – intralesional injection has the highest rate of success.


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