Keloids: scar revision

The treatment of keloids can be a long-term, and at times, vexing, dermatologic surgical management problem arising in both white and non-white patients. This paper reviews a number of conventional, as well as novel, therapeutic approaches for the management of this disease of uncontrolled scar growth. Additionally, fundamental aspects of this disease are covered, including clinical, histologic, biochemical, immunologic, endocrinologic, and epidemiologic factors. An understanding of these latter aspects may be useful to the clinician in realizing the best possible therapeutic results. It must be emphasized that, regardless of the technique employed, an observation period of at least 2 years is necessary to effectively limit the chance and degree of recurrence.