The most effective way of treating keloid scars is an injection of steroid into the scar.
Dr Jennifer Crawley:
The intralesional injection has the highest rate of improving the scar. In the majority of cases, this offers a permanent solution.
Miss Jane Olver: Can the injection of intralesional steroid cause side effects such as thinning of the skin or prominent blood vessels or anything like that?
Dr Jennifer Crawley: It can cause changes in the skin, Jane. And obviously, before I do any intralesional steroid, it is imperative that I discuss that with the patient in detail. We do the correct consent form, and I make sure everyone is aware of the side effects.
Miss Jane Olver: Do it have local anaesthetic in it?
Dr Jennifer Crawley: It does not have a local anaesthetic.
Miss Jane Olver: Do you give local before?
Dr Jennifer Crawley: No. We don’t give local anaesthetic beforehand. Side effects can include bleeding, infection of which the risk is very low, pigmentary change and as you say Jane skin atrophy or thinning of the skin.
Miss Jane Olver: Is keloid scar injection treatment available on the NHS?
Dr Jennifer Crawley: Yes it is Jane, but sometimes there is a wait for treatment within departments, but yes it is available.
Miss Jane Olver: Is there any other area or condition where you use intralesional steroids?
Dr Jennifer Crawley: Sometimes we inject an intralesional steroid into areas of hair loss on the scalp. So if you have some areas of alopecia areata where you get very well circumscribed, tiny areas of total hair loss on the scalp or the eyebrows, then intralesional steroid can be a proper treatment. This is something that we will offer here at Clinica.
Miss Jane Olver: I never knew about that, thank you very much. We will go on from keloid now to another area that I know interests you because you are a dermatologist and you work with a lot of drugs that are quite modern and new and you treat a lot of patients with psoriasis.