One of the common ways to treat keloids is keloid injections. In this procedure, the doctor will inject corticosteroids directly into the keloid, which is a scar tissue that grows prominently and is wider than the original wound.
When the skin is injured, the body's cells naturally form scar tissue to cover and heal the wound. However, in people with keloids, this scar tissue grows excessively beyond the area of the wound. Keloids can look like pink bumps with a smooth surface.
The most commonly used corticosteroid drugs for keloid injections are: triamcinolone acetonide. Several other types of drugs, such as 5-fluorouracil and bleomycin, can also be combined with triamcinolone to provide optimal results. Research shows that keloid injections with triamcinolone gives good results in 50–100% of cases, with a recurrence rate of only about 9–50%.
How Keloid Injections Work and Effects
Corticosteroid medications used in keloid injection procedures can help reduce the size and improve the appearance of keloids in several ways. Here is the explanation.
- Corticosteroids can reduce the inflammatory process (inflammatory) that occurs in keloids by inhibiting the movement of white blood cells, such as monocytes and phagocytes, to the wound area. This can prevent a worsening of keloid symptoms, such as itching and pain.
- Corticosteroids can prevent existing fibroblast cells from forming more fibroblasts. These fibroblast cells are cells that produce scar tissue.
- Corticosteroids can inhibit the development of keratinocyte cells, which are the producers of dense protein in the skin, and slow the growth of new skin epithelial cells in keloids.
- Corticosteroids can inhibit the formation of new collagen in the keloid tissue and maintain the work of the collagenase enzyme in decomposing the already formed collagen.
Keloid Injection Procedure
Corticosteroid drugs will be injected directly into the problem area (intralesional injection), namely keloid tissue. Here are the steps in the keloid injection procedure:
- The doctor will clean the keloid and the surrounding area with an antiseptic solution, before injecting corticosteroid medication. This is to prevent bacterial infection at the injection site.
- Corticosteroid drug fluids can be given with or without dilution. Dilution can be done using saline or anesthetic to reduce pain.
- Corticosteroids will be injected directly into the keloid bulge using a fine needle.
- Injections will be repeated regularly every month or every few months.
Research shows that keloids appear to begin to soften about 3 weeks after the injection is made. Within a period of 5 weeks, keloid protrusions begin to shrink and become flatter.
Side Effects of Keloid Injections
Although relatively safe, keloid injections can still cause side effects in the form of local reactions in the keloid area only or wider (systemic) reactions. Here are some of the side effects of keloid injections:
- Telangiectasia, characterized by the appearance of fine red streaks in the keloid area due to the dilation of the small blood vessels underneath
- Thinning and breakdown of skin tissue and fatty tissue under the skin (atrophy)
- Changes in skin pigmentation, so the skin at the injection site will be darker or lighter in color than the surrounding skin
- Bleeding, wounds, and skin infections
- Cushing's syndrome is caused by an increase in the amount of the hormone cortisol in the body
Keloids generally do not go away on their own, they can even continue to grow. Therefore, if you have keloids and want to get rid of them, consult a dermatologist to see if your keloids can be treated with keloid injections or need other treatment.
In addition, so that the keloid does not get worse, you are also advised to protect the keloid from sun exposure and friction with clothes.
Written by:
dr. Irene Cindy Sunur