Treating facial keloids, much like other keloids, can be challenging and time consuming. Patience and perseverance are the two most important factors in achieving successful treatment results. Treatment of facial keloids has two phases:
Phase 1: Remission induction or debulking the keloid tissue.
Phase 2: Maintenance treatment.
With a proper treatment plan, one has to first reduce the mass and bulk of the keloid tissue. This step will require several rounds of non-surgical treatments, often with cryotherapy. Once the keloids are made flat, an on going evaluation and maintenance plan will address any possible recurrence and/or new keloid spots that form.
28-year-old gentleman presented with several keloid lesions on both sides of his face. He had developed his first facial keloid about 4 years earlier and since then had received several steroid injections and also undergone surgery. Despite all the care he had received, his facial keloids have regrown, causing his considerable discomfort and anxiety/depression. He had constant infection and purulent drainage from the keloids on the right side of his face. This young man used to wear hoodies at all times to conceal his keloids. With proper medical treatment, using combination of cryotherapy and intra-lesional steroid injections, we were able to control his keloids within a year. Thereafter, he would return to the office for spot-treatment of new spots, or areas that start growing.
Treatment of facial keloids has to be customized for each patient. Course of treatment varies from weeks to months, depending on the extent of keloids. Surgery and Radiation therapy should be avoided all together for facial keloids.