Keloid Specialist

Not to do list: when suffering with keloids

Keloid in dark population is more than 10%. Though it is so common, no uniformly effective treatment is available. Any unwarranted injury has a potential to develop a keloid. So avoidance of injury is the best strategy. Try to avoid un necessary surgery. Following procedure have high risk of keloid formation in keloid prone individuals

neck tattoo


Reaction to Tattoo ink is common. Tattoo injury itself or tattoo ink reaction can trigger new keloid in predisposed individuals. If you have even a small keloid, refrain from this activity.

keloid treatment

Laser tattoo removal

Laser tattoo removal in keloid patient has fairly high potential of developing new keloid. So don’t opt for tattoo removal unless it is really necessary. Choose an experienced dermatologist who has expertise of avoiding keloid or treating keloids.

keloid treatment

Deep chemical peels or laser surgeries

Deep chemical peels are NOT safe in dark skin. They cause burn which can lead to keloids in predisposed individuals. Same is about ablative lasers like CO2 or Er YAG or MNRF.



Slowly healed wound of surgery, inflammatory reaction to stitch thread can initiate keloid. Your surgeon need to have expertise of anticipating and treating keloids. Or else involve your keloid treating doctor in surgical plan or see him immediately after suture removal to plan keloid prevention.

ear keloid

Nose ear or body piercing

In prone individuals body piercing has very high chance of recurrence of keloid so it is better avoided.

Whether keloid should be operated or not is an area of great controversy. Keloids not only re-occur after surgery, but often are often bigger in size and much harder to treat. In first place The onset of a keloid is triggered by wounding of the skin. In surgical keloid removal, a much bigger injury is induced by the surgeon. This new and larger injury will obviously result into formation a much larger keloid. The risk of recurrence after surgery for certain keloids such as chest wall, shoulder keloids is near 100%. Local injection of steroids or chemotherapy or radiation after surgery may reduce the risk of recurrence of certain keloids. These interventions have their own limitations and side effects. Flat, small and minor keloids should never be treated with surgery. It commonly observed that a surgeon has removed a small keloid from the skin, and the result has been worse than the original keloid. If keloid is a genetic and an inherited disorder of wound-healing, how Surgery canchange the outcome? Surgery only triggers the abnormal wound healing response, which is the core problem in keloid formation
Radiation therapy is also utilized to reduce the risk of keloid recurrence after surgery. Although it can reduce the risk of recurrence to some extent, radiation carries a definite risk of causing cancer and therefore should not be used to treat a benign condition such as keloid. All current machines and protocols available in India are not safe for using in keloids. Only technology cleared by US FDA for keloid is SRT100 whose efficacy is proven beyond doubt, but safety is to be established.
Surgery does more harm than good to keloid patients so it is better to be avoided. In spite of so many treatments available outcome in individual patient is highly unpredictable. Steroid creams and injections usually trigger acneform rash or folliculitis leading to fresh keloid formation while surgery give recurrence of more aggressive keloid. “Giving patients false hopes is another major problem when it comes to keloid treatment. Many of the treatments can in fact make the keloid scar look worse. If one has no idea what to do, the best advice is to leave the keloid alone!” These are comments by scientific author Sarah McGinty; Waqas J. Siddiqui. While writing on keloid in a medical journal.
Historically most common treatment used in past for keloids is steroids only. It can produce excellent results in short period but does not affect keloid progression. In fact most of the keloids which are slowly progressing become more aggressive after injection therapy. Steroid creams if used in wrong potency will cause either skin atrophy in surrounding skin. It induced acne and folliculitis in and around keloid. These follicular inflammation and infections act as trigger for growth of same keloid and occurrence of new keloids at periphery. Steroid injections given into bulk of keloid usually give impressive thinning of keloid. Steroids comes in variety of potency and strengths. Triamcinolone is commonly used steroid available in 10 to 40mg/ml strength. Dilution, depth of injection, quantity, interval between injection all matter in final outcome. Most doctors lack the skill and experience of using steroids in correct protocol and dosage. Common practice of injecting steroid into keloids have more harm than good. Dr Dhepe warns doctors and patients to refrain from inadvertent use of steroid of in keloids.
Steroid injections given in too high dose and too frequently have led in systemic steroid toxicity. This patient has developed new steroid induced acne after steroid injections. His previous few lesions now ended into hundreds of iatrogenic keloids. Steroid induced atrophy at pressure points. This patient has developed atrophy on shoulder. Bone is palpable just beneath thin skin. Remember not entire scar tissue is to be dissolved. Less is more ! Beauty of using steroids in keloid treatment lies in using it sparingly or avoiding it. Using in very less dose, correct dilution, correct depth of injection, correct size of bolus of injection all of these make a great result. Mixing the steroid into other chemotherapy drugs in right proportion is another expertise. All these combinations should be tailor made for each patient. Just pushing steroid into keloid will make a disaster. Your doctors need to have expertise in all these aspects before he treats you.

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