Keloids are dense, benign growths found mainly on the chest, back, shoulders, neck and earlobes; they extend beyond the boundary of an original injury. A study reviewing keloid symptoms published in 2004 in the "Journal of the American Academy of Dermatology" showed that 46 percent of the study's subjects reported pain, while 43 percent reported hypersensitivity to touch. The pain and hypersensitivity to touch may be due to small nerve fibers which are compressed by the extra collagen fiber seen in keloids.
Intralesional Corticosteroids
Intralesional corticosteroids, usually triamcinolone acetonide, have been used for many years in the treatment of keloids. Intralesional corticosteroids have been successful in reducing symptoms, including pain, in a number of patients.
Silicone Gel
Silicone gel is a noninvasive, inexpensive form of treatment; however, it has to be used for 6 to 12 months and 12 hours a day. Silicone gel may improve the hydration of the keloids, and has been shown in a study published in "Dermatological Surgery" in 2001 to reduce keloid-associated symptoms, including pain, significantly.
Botulinum Toxin A
Botulinum toxin has been used to control pain in a number of disorders, though the exact mechanism by which it works remains unclear. A case report published in 2010 in the "American Journal of Physical Medicine and Rehabilitation" discussed a patient with a painful keloid who had undergone numerous previous treatments. The previous treatments had either had no effect on the pain or made the pain worse. The case report showed that an injection with botulinum toxin improved her pain significantly.
Cryotherapy
Cryotherapy is usually restricted to small keloids, because it can be both painful and result in prolonged healing. Local anaesthetic is applied, and liquid nitrogen is used to freeze the scar. A study by the National Skin Center demonstrated that the combined use of intralesional corticosteroids and cryotherapy significantly reduced the pain of the keloids after treatment. The same study also showed that cryotherapy alone and intralesional corticosteroids alone reduced pain associated with keloids.
Radiotherapy
A 2007 study conducted at the Department of Radiooncology at the University of Heidelberg and published in the "International Journal of Dermatology" showed that the combination of surgical excision and radiotherapy improved keloid symptoms, including pain, in 81 percent of patients. This same study showed that 12 of the 47 patients involved in the study were not satisfied with the appearance of their keloids after this treatment.
References
- "Journal of the American Academy of Dermatology"; Pruritus, Pain, and Small Nerve Fibre Function in Keloids: A Controlled Study"; Lee et al; 2004; Dec. 1951
- National Skin Centre; A Comparative Study of Combination Intralesional Corticosteroid with Cryotherapy vs. Intralesional Corticosteroid and Cyrotherapy Alone in the Treatment of Keloids in Adolescents; G. Yosipovitch; 1995
- "Dermatologic Surgery"; Silicone vs, Non-silicone Gel Dressings: A Controlled Trial; GV de Oliveira, et al; Aug. 27, 2001
- "American Journal of Physical Medicine and Rehabilitation"; Treatment of Painful Keloids with Botulinum Toxin Type A; B. Uyesugi et al.; Feb. 2010
- "International Journal of Dermatology"; Postoperative Electron Beam Radiotherapy for Keloids: Objective Findings and Patient Satisfaction in Self-Assessment.; M. Bischoff, et al; Sept. 2007
