Keloids and hypertrophic scars - Keloid treatment center - Keloid Treatment New York City

Keloids and hypertrophic scars

Keloids are formed from excessive scar tissue formation at the site of prior skin injury. Keloids have a tendency to extend beyond the area of the original skin injury or wound. The cause of keloid formation, and why some people are prone to it and some are not, is not well known. African-Americans are more prone to develop scars and keloids than others. Keloids vary in size and can occur on any part of body. Keloids can occur as a result and subsequent to a variety of injuries to the skin:

  • Skin burns
  • Acne
  • Chicken Pox
  • Ear piercing
  • Scratches
  • Surgical incisions
  • Vaccination sites

earlobe keloids

Earlobes are very common places for Keloid formation. To learn more about Earlobe Keloids, please visit our dedicated information webpage for

Earlobe Keloids

Keloids are fairly common in young African-Americans and, in severe forms, can become disabling. Size and location of keloids determine the symptoms and the issues that they can cause. Some keloids are small and cause a cosmetic concern only. Larger keloids, especially when located in a critical part of the body, can interfere with daily life, sleep, or other body functions. Large keloids in the earlobe can interfere with sleep as well as hearing and the ability to discern direction of the sound. Treatment of keloids depend on their location, size and thickness. Surgery has traditionally been counterproductive since removing one scar or keloid can result in formation of another one on the same site.

Treatments for Keloids and hypertrophic scars:

Successful treatment of keloids requires patience and perseverance. As keloids are chronic skin conditions, their treatment also takes time. Each keloid may require more than one method of treatment to achieve a desirable result.

Choice of treatment for a given Keloid will depend on its location, size and thickness. I often use cryotherapy for treatment of large and bulky keloids. Freezing works very well and often the keloid comes off completely after few treatments. Once this is achieved, the skin must be closely monitored for early signs of recurrence.

cryotherapy for Keloids and hypertrophic scars:

The fundamental approach to treatment of keloids is to destroy the keloid tissue with a method that results in the least chance of recurrence. Cryotherapy does exactly that. Below is an example of how well cryotherapy can work for keloids. This patient had developed a keloid at the site of a naval piercing and had undergone other treatments without success. I treated this keloid only once with cryotherapy. The entire mass of this keloid fell off in about a month with excellent results.

Medical literature supports usage of Cryotherapy for this condition. In 1993, Italian physician Dr. Rusciani published his experience with 65 Keloid lesions (J. Dermatology Surg. Oncol., 1993. Jun 19 (6): 529-34. Use of cryotherapy in the treatment of keloids) and concluded that:

"Cryotherapy is an effective, low risk approach to keloid treatment associated with a low rate of recurrence.

In 2005, Dr. Fikrle, from Czech Republic, published his experience with cryotherapy as monotherapy (that is just using cryotherapy, without any other interventions) in seven cases of earlobe keloids (Dermatol. Surg., 2005. Dec 31 (12):1728-3). Dr. Fikrle observed that the volume of the keloids reduced in every patient and that complete flattening of the scars/keloids occurred in five out of seven patients and concluded his publication, stating:

"We present an excellent effect of cryosurgery as the monotherapy for the treatment of earlobe keloid scars of young patients."

My approach and Treatment for Keloids and hypertrophic scars:

Keloids are chronic skin conditions that require a comprehensive treatment plan and approach. Most keloids need more than one modality of treatment. My approach to treatment of keloids is to design a step by step non surgical treatment plan for every patient. This plan takes into consideration the location, size and thickness of the keloid as well as the associated symptoms. Some keloids can be treated with cryotherapy alone, others need to be injected with steroids first and, if they do not respond to this treatment, cryotherapy is used in the second stage. If all these fail, one may need to even incorporate surgery, as a step to gain control over the process.

Once a keloid regresses after cryotherapy, it is important to monitor the site and look for evidence of recurrence. If the treatment site shows any evidence of recurrence, the site is then injected with steroids or chemotherapy drugs to prevent local recurrence.

Although Keloids are difficult conditions to treat, the good news is that everyone with Keloids can be helped in one form of treatment or the other. Treatment of heavy scars and keloids take time. Each treatment results in some improvement in the appearance of the keloid. In most patients, treatment needs to be repeated to achieve best results. The below videos demonstrate how I apply cryotherapy to keloids.

Cryotherapy can be applied to most keloids without any anesthesia. This is an out-patient procedure. The procedure is relatively well tolerated. Even larger keloids can be treated with cryotherapy on an out-patient basis. When needed, I inject the skin before applying cryotherapy. Using local anesthetic makes the process of freezing the keloids much easier.

The below images illustrate the treatment result of a large keloid that was complicated with recurrent infections. This keloid has been present for years and would, on a regular basis, become infected and require days and weeks of oral antibiotics.

This keloid was treated with Cryotherapy once and the whole keloid mass came off after about a month. The follow up image was taken about 3 months after the treatment. The skin will continue to heal and the natural skin pigmentation will most likely expand to cover the central area of the skin. If pigmentation does not occur adequately, I would then treat the skin that lacks pigment with a simple cosmetic tattoo treatment to match the skin color to the surrounding area.

Below is another very large keloid located on the right buttock. This keloid responded extremely well to cryotherapy. It took about 20 minutes to freeze it. It fell off completely in about six weeks. Not all keloids respond this well to treatment. The response spans from a complete destruction of keloids in one treatment, as depicted below as well as the above listed keloid, to a less than complete response, whereby part of the keloid will fall off and the remainder will need additional treatments. The skin site in the image below, will need several weeks to fully heal.

Below are images of a very large Keloid which I treated with cryotherapy. This particular keloid was interfering with with sleep of this patient. He would wake up with pain and discomfort, because his keloid would get caught and pull against his mattress. After one treatment, there was marked shrinkage in the size of this keloid, allowing this patient to sleep well at nights without interruption. We still have work to do to treat the residual keloid, which will need another cryotherapy.

This Keloid mass reduced by about 80% after one treatment. We are now planning for second treatment for this particular Keloid. I will post an update to this keloid once we treat it.

Treatments for superficially spreading keloids

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