Injection treatment for keloid scars is currently one of the most popular methods.Medication for treating keloid scars using corticosteroids. Although this method can be effective, injecting corticosteroids into keloids also has certain advantages and disadvantages.
1. What Is a Keloid?
A keloid typically forms as the result of the body’s own healing process. When the healing process loses control of new cell growth — especially excessive collagen production and uneven growth of tissues — it can lead to raised scars that protrude above the surrounding skin.
Keloids appear as nodules with clear boundaries and sizes that depend on the extent of the original wound. However, keloids can continue to grow in both size and volume over time, spreading into healthy skin areas.
Keloids may develop on many body parts, such as the face, legs, arms, back, shoulders… Regardless of their location, keloids affect one’s appearance and can cause uncomfortable symptoms like itching, burning, or tightness in the skin.
2. Causes of Keloids
Keloids commonly result from several factors:
- Skin injuries that are not properly treated, leading to infections, which promote keloid formation.
- Improper pimple popping, such as piercing immature pimples or using non-sterile tools, causing inflammation and resulting in keloid scars.
- Keloids may form after surgeries, burns, or trauma from traffic accidents if the wounds do not heal properly
- Genetic predisposition: Individuals with a family history of keloids are more likely to develop them.
- Dietary factors during wound healing, such as being overly restrictive or consuming certain foods (like water spinach, chicken, shrimp, sticky rice), can encourage keloid formation.
3. Treating Keloids by Injecting Corticosteroids
Corticosteroids help reduce keloids and rapidly growing hypertrophic scars. Keloid treatment injections are currently popular, such as Triamcinolone, which belongs to the corticosteroid group – a class of anti-inflammatory drugs with slow and prolonged effects. Does corticosteroid injection for keloids have adverse effects? Corticosteroids help soften scar tissue and inhibit excessive growth of epithelial cells and collagen.
Mechanism of Action of This Treatment:
- It effectively suppresses inflammation in the wound by inhibiting the movement and phagocytic function of white blood cells.
- Because corticosteroids cause vasoconstriction, they reduce the delivery of oxygen and nutrients to the scarred area, limiting abnormal tissue overgrowth.
- Corticosteroids act on alpha-2-macroglobulin, which inhibits the enzyme collagenase (the enzyme that breaks down collagen).
- Corticosteroids also reduce protease inhibitors in the bloodstream, thereby allowing collagenase to break down collagen, inhibiting excessive collagen growth.
- Additionally, corticosteroids can inhibit cell division and slow down epithelial cell and collagen proliferation.
Steps in Injecting Medication for Keloids:
- Before undergoing keloid scar treatment, a doctor will examine and assess your scar’s severity. Based on this evaluation, specific recommendations regarding the injection dosage and treatment schedule will be provided to ensure suitability.
- Before the corticosteroid injection, the scar area is cleansed and disinfected to prevent infection. Local anesthesia is often applied because the injection can cause localized pain.
- The doctor proceeds with the corticosteroid injection to flatten the keloid. Even with local anesthesia, you may still feel some discomfort, which is normal.
Keloid treatment with injections typically requires about two sessions on average, although the exact number depends on the scar’s condition. Each session might be spaced 1–2 weeks apart. Follow your doctor’s instructions during the treatment period.
4. Advantages and Disadvantages of Corticosteroid Injection for Keloids
Using corticosteroids in keloid treatment can yield fast, noticeable results, but there are potential risks that may impact your health and skin.
4.1. Advantages of Corticosteroid Injection
Corticosteroid injections for keloid treatment can offer advantages such as:
- The treatment of keloid and hypertrophic scars with corticosteroids can deliver rapid and remarkable results by directly acting on and inhibiting alpha-2-macroglobulin, which suppresses collagen overproduction, thereby causing the scar to flatten quickly..
- About 70–80% of patients respond positively to corticosteroid injection therapy.
- This method suits those wanting to permanently remove keloids while avoiding the time-consuming nature of certain other treatments.
Moreover, keloids easily recur after treatment. Compared to more traditional keloid therapies, the recurrence rate may be significantly lower with corticosteroid injections.
4.2. Disadvantages of Corticosteroid Injection
Despite its advantages, injecting corticosteroids for keloids can pose certain health and skin risks:
- The corticosteroid injection method for treating keloid scars may cause localized side effects such as skin thinning, skin atrophy, skin erosion, and pigmentation disorders. These disorders can lead to uncontrolled skin color changes in the treated area, making it either lighter or darker than the surrounding skin. Additionally, other side effects may include ulceration, necrosis at the injection site, vascular dilation, excessive hair growth, increased acne breakouts, and muscle weakness.
- The corticosteroid injection method for treating keloid scars can also cause systemic side effects, including Cushing’s syndrome, adrenal insufficiency, an increased risk of gastric and duodenal ulcers, menstrual irregularities, and gastrointestinal bleeding.
- In some cases, injected corticosteroids might accumulate in healthy skin areas, worsening systemic side effects, particularly in children.
- Some symptoms require special attention if they occur after corticosteroid injections for keloid treatment, including excessive weight gain, depression, or the onset of amenorrhea in women. If you experience these symptoms, you should consult a doctor for timely advice and treatment.
- Additionally, corticosteroid injections for keloid treatment require the use of local anesthetics; however, patients may still experience pain during the procedure. Therefore, the treating physician must perform the injection technique with precision to prevent complications and ensure the patient’s comfort
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