treatyourscars Corticosteroid injections following keloid surgery reduce the recurrence rate to less than 50 percent. Scar excision may be completed or a few minutes of residual scar may remain at the wound margin, which may reduce recurrence (based on expert judgment) The surgical removal of keloids is almost always accompanied by an even more aggressive regrowth of scar tissue (50 to 100%).
A wide range of treatments are available to improve the appearance of scars such as acne treatments for minor wounds, such as Vitamin E creams and silicone gel pads, but research has not shown that they are consistently effective. Fortunately, there are topical scar treatments that do not require needles or many unwanted side effects.
Unfortunately, no specific treatment has been proven to be effective in preventing scarring. Studies designed to evaluate the effectiveness of silicone dressings in reducing scarring are of poor quality, so their usefulness for treating hypertrophic or keloid scars or preventing their formation are unclear. Silicone gel technology has been on the market for over 30 years and numerous clinical studies have shown its effectiveness in reducing the appearance of keloids and hypertrophic scars. Silicone gel technology is a hypoallergenic alternative to scar
One 2014 review suggested that topical corticosteroids reduce the appearance of abnormal scarring by reducing inflammation, increasing the breakdown of collagen (the main protein making scars) and decreasing collagen production. The authors of a 2014 paper ibid.24 ask the same question and conclude that “in theory, topical corticosteroids can reduce abnormal scars by reducing inflammation and activating the ducts of the skin.”
However, it is unclear if hydrocortisone can minimize acne scars in particular. A small study conducted in 2017 suggests that a similar synthetic corticosteroid called methylprednisolone may help prevent postoperative scarring. A potent corticosteroid called fluocinolone acetonide has been applied to wounds topically in an attempt to reduce excess scarring.
Scars are usually formed as a result of hyperproliferation of fibroblasts with subsequent overproduction of collagen. The increase in hypertrophic or keloid scars in burns appears associated with intense and prolonged inflammation that usually occurs in this type of wounds and the resulting overgrowth of fibroblasts and collagen production. If excess scar tissue has formed, a hypertrophic scar (red, bulging, worsening several months after wound formation and improving spontaneously over the next 1–2 years)
Injection of corticosteroids into the scar can soften, narrow, and flatten it. Steroid injections are commonly used to treat hypertrophic and keloid scars (in addition to a pulsed dye laser). Intrafocal Steroid injections for raised and abnormal types of scars are a common form of treatment suggested by most dermatologists.
Intra-soil injection of corticosteroids to prevent and treat keloids and hypertrophic scars is a practical first-line method for family doctors. According to the National Library of Medicine, intramuscular steroids can also be injected into the tissue bed to prevent overgrowth of scar tissue.
Many patients use topical vitamin E (alpha-tocopherol) in the hope that its antioxidant properties prevent scarring, a widespread use of which is proved by years of clinical research, is evidence of the effectiveness of injections to the lesion. Most patients see an improvement in the appearance of their scars with just a few treatments with dermatologists.
Studies have shown that topical use of a corticosteroid cream for the treatment of HS is promising, with higher satisfaction rates than a silicone-based control group.20,21 It is recommended to delay intralesional corticosteroid injections for patients with postoperative linear scars. which cannot be treated with prophylactic treatment (silicone gel, pressure treatment, hydration, tape ) or in patients with recurrent hepatitis B. 9,10,22
Double Injection of 5-fluorouracil injections in the lesion in treating hypertrophic and keloid scars on the face : Margaret Shanti FX, Ernest K., Winkler E. Comparison of intralesional verapamil with intralesional triamcinolone in the treatment of hypertrophic and keloid scars.
Comparison of the topical silicone gel and topical tretinoin cream for preventing hypertrophic scarring and keloid formation and improving scarring Effect of pulsed dye laser pulse width of 595 nm on the response to treatment of keloid and hypertrophic sternotomy scars
Alden et al. 43 evaluated the use of flurandrenolone tape (4 mg / cm2) in a cohort of 100 patients. Patients who used corticosteroid cream experienced less severe scarring after surgery than those who used silicone gel.
