Keloids: A troubling condition for patients

A keloid is a growth of extra scar tissue where skin has healed after an injury from wounds typically caused by acne, burns, piercings, cuts, scratches, surgical incisions, and vaccinations. Keloids are more prevalent among people with darker skin tones and are commonly found on the ears, neck, chest, and back.

While many keloids do not require treatment, some may become itchy, painful, or aesthetically unpleasing. Quality of life may be greatly diminished depending on the severity of the cosmetic disfigurement, functional impairment, or psychosocial trauma caused by the excessive scarring. Patients may also incur substantial financial costs seeking a solution. Unfortunately, keloids frequently reoccur after treatment, causing even more emotional and financial strain. Consequently, it is critical to select the most effective treatment option for first-line therapy.

Surgical removal and radiation: The recommended treatment to avoid keloid reoccurrence

There are several treatment options for keloids, including steroid injections, cryosurgery, laser therapy, silicone gel sheets, surgical excision, external radiation therapy, brachytherapy, and surgical removal followed by radiation therapy. All of these treatments, except the combination of surgery and radiation, are largely ineffective, and the lesions often return.

An extensive body of research conducted over the past several decades strongly supports the use of postoperative radiation therapy for keloid treatment. A retrospective review of records at two academic institutions for keloid treatment using radiation therapy over a 15-year period concluded “Surgical excision followed by immediate adjuvant radiation therapy provides excellent local control and cosmesis with minimal toxicity.” In another large study, 375 keloid sites on 250 patients were treated with therapeutic irradiation after excision. Researchers determined the “Cosmetic result was considered excellent without reoccurrence in 92 percent.” Other studies have reported similar findings, with reoccurrence-free success rates ranging from 81.1 percent to more than 90 percent.

Immediacy of radiation therapy following surgery affects short and long-term results

A retrospective study of 568 keloid cases with 834 lesions, with treatments taking place February 1998 through January 2012, shows that patients who had radiation therapy within 24 hours of surgery had a significantly better prognosis.

Interval time from surgery to radiotherapy

 Result of treatment response (n)
 Well controlled

 Median control time and confidence interval (months)
Level I Level II Level III Level IV
≤24 (641) 426 168 8 39 92.67% 51 (48.96-59.69)
≤48 (49) 26 11 6 6 75.51% 41 (36.42-47.56)
>48 (144) 85 20 4 35 72.92% 36 (34.07-37.22)

Safety comes first

The safety and well-being of patients are always top priorities. The long history of utilizing radiation therapy after surgical excision for the treatment of keloids has largely proven its feasibility and safety. Extensive studies have shown postoperative radiation treatment for keloids to be very safe with a diminishingly small risk of carcinogenesis.

An extensive literature search covering over 100 years demonstrates the safety of keloid radiation therapy

Historically, there has been concern among some physicians that treating keloids with radiation therapy could induce malignant tumors, but that risk has been proven to be very low.

A 2009 article in Plastic and Reconstructive Surgery reported the findings of researchers who conducted a computerized literature search of PubMed, MEDLINE, and PubMed Central citations between 1901 and March of 2009 to find reports of associations between carcinogenesis and keloid radiation therapy. Only five were found, and in those cases, it was unclear if appropriate doses of radiation were used or if surrounding tissues were adequately protected.

The researchers concluded “…the risk of carcinogenesis attributable to keloid radiation therapy is very low when surrounding tissues, including the thyroid and mammary glands, especially in children and infants, are adequately protected, and that radiation therapy is acceptable as a keloid treatment modality.” Additionally, when radiation oncologists around the world were surveyed, 80 percent considered radiation therapy to be an acceptable and safe treatment for keloids.

Our expertise and personalized protocol support success

We have many years of experience providing radiation therapy for patients with keloids, giving us a deep level of expertise in treating this condition. Our comprehensive keloid protocol, delivered by a team of highly trained, compassionate specialists, ensures patient safety, optimal outcomes, and a positive patient experience. Our patient-centric approach incorporates proper patient selection, multidisciplinary consultations, and extensive preparation prior to procedures. We collaborate with referring providers, surgeons, and all members of the patient’s care team to create a custom-designed treatment plan.

Typically three treatments are given, once a day for three days. Wound care is provided post-therapy, along with short-term use of inflammation modulating agents. Our care team continues to monitor and assist patients for as long as they need our support. Our highest priority is helping patients achieve the best possible outcome.

Our postoperative keloid therapy is the recommended, clinically proven solution to prevent keloid reoccurrence, providing patients the best opportunity for optimal, long-term results. To learn more about this safe and effective treatment, please contact us today.