[Modern treatment of keloids]

Keloids are a benign proliferative growth of dermal fibrous tissue, usually resulting from an excessive tissue response to skin trauma or disease in predisposed individuals. The basic cause is unknown. Hypertrophic scars are similar lesions but they will, in time, show some degree of resolution. These lesions can be aesthetically disfiguring and cause functional disturbances. This paper reviews current knowledge of the treatment modalities for keloids and hypertrophic scars. Most physicians emphasize the importance of prevention. No single therapeutic modality is the best. Current various treatment options of keloids and hypertrophic scars are: surgical treatment, radiation, medicamentous treatment, treatment by mechanical pressure, and laser therapy, each alone and in various combinations. The published recurrence rates for keloid treatments vary widely, although they are the lowest for the combination of surgery and radiation, but other measures may be useful. Some keloids and hypertrophic scars may respond to intralesional triamcinolone and verapamil, but results were significantly better in early lesions. Clinical trials of intralesional administration of gamma-interferon, as well as topical application of retinoids have caused reductions in keloids. Pressure treatment is widely accepted. Laser therapy which selectively injures cutaneous microvessels without inducing scars may be successfully used in the treatment of keloids and hypertrophic scars.