In this video, Dr. Fernando Amato talks about keloid treatment.

How is keloid treated?

This is a question that patients
come, bring, and send messages to the

office asking how much
a keloid treatment surgery costs.

Well, I am Dr. Fernando Amato and today I
will talk about keloids. A keloid is an

anomalous scarring.

It is an exaggerated scarring.

Generally, there is trauma to the site, there is
a healing process happening,

there was surgery at that site, but sometimes
keloids can appear in places where there was no

surgery.

Some patients have, sometimes
from acne scars, pimples.

So these patients who have keloids,
they need to understand that keloid treatment

is not just surgery and they shouldn't
choose the treatment.

“I want to have surgery, I will look for a
professional who performs surgery.”

Please, don't do that!

Keloid treatment is much more
complex, there are patients who have

keloids in one scar
but not in another.

Some patients have keloids in
several places on their body, and some patients

have a family history of keloids.

There are family antecedents of
keloids; the mother has it, the brother has it.

So each patient will be different
and each patient will have their own treatment.

It is important for the patient to be
aware that keloid is an

anomalous scarring, it is a hyper-
proliferation of the scar with an irregular

collagen arrangement that happens in the
scar and is very different from a hypertrophic scar.

A hypertrophic scar is a slightly raised
scar, but a keloid goes beyond the scar.

It invades, it forms a ball, sometimes
it grows far beyond the scar.

This is the difference; hypertrophic scars often
resolve themselves, sometimes they need local treatment,

but often over time they even flatten. Keloid treatment
is extensive; it can involve

infiltrations with corticosteroids. Corticosteroids
can reduce the volume of the keloid a little,

these infiltrations we use
a lot of triamcinolone.

Keloids have symptoms, often the
patient has pain or pruritus, which is that itching

in the scar.

And these patients who have symptoms are the
ones who benefit from this corticosteroid infiltration,

and surgery can be performed
to resect this tissue.

This scar can be hydrated
and often these scars become dry.

This improves the
healing process.

There are silicone sheets that help
compress and hydrate the scar, so they

also help in this
process.

When we perform resection surgery,
we take special care to try to prevent the scar from

reoccurring.

And there is also beta-therapy.
What is beta-therapy?

Beta-therapy is radiotherapy applied to the
scar that reduces local immunity

to prevent exaggerated scarring
after surgery.

So generally, a very common protocol
is to perform triamcinolone infiltrations

until a certain regression and
improvement of symptoms occurs.

Perform surgery and then, post-operatively,
undergo beta-therapy sessions.

This is a very common protocol, but other
procedures can be done, laser can be used

to decrease keloid vascularization,
compression with silicone sheets can be done,

there are moisturizing creams that can be
used, a little topical corticosteroid can be used,

and other work is
happening, other procedures

that can be injected locally, even fat grafts.

There is also oral, dietary treatment.
Some patients,

they may have certain foods that are more
inflammatory, which could increase inflammation

and cause keloids.

So these inflammatory foods, which
will be different for each patient but some patients

know them as “heavy” foods. But some foods are actually
more inflammatory, we know, for example,

that gluten is more inflammatory, but it will not
be more inflammatory for everyone, but many people

suffer when they eat gluten. But there are these
inflammatory foods that could be

influencing the scar
and contributing to the keloid.

There are even studies showing a
psychological influence where keloids appear at the most

stressful times in the patient's life.

There are also studies showing that
there is a hormonal influence on healing

that could be influencing keloid formation.

So for each patient
there is a treatment.

Treatment is not just surgery!

It is generally composed of several
associated treatments and it is important that the

treatment must be individualized.

So if you have keloids, or know
someone who has keloids and wants treatment. If you liked the video, like it, comment,
you can comment, if it's a question we try to help

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share it with someone who needs this

information. Thank you very much!