Biology and behavior of keloids vary, not only from patient to patient, but often from keloid to keloid in the same individual. Some keloids are totally asymptomatic; they don't hurt, they don't itch, and they don't cause any problems. On the other hand, there are keloids that are either painful, or they itch (or both).
There is a subset of flat keloids that are inherently very painful. These keloids are often located in the mid-line of chest. They are very tender to touch and they ache and hurt all day long. For these patients, pain is the most troubling symptom of their keloid. Term Hyper-Inflammatory keloid applies to this subset of keloids
Management of Hyper-Inflammatory keloids is quite challenging. Pain control is cornerstone of managing these patients. Dr. Tirgan's approach to these keloids is a two prong approach: a) pain control, b) control of the keloid process. Dr. Tirgan uses chemotherapy as his first line of treatment, as most these keloids have already been treated with every known treatment modality.
In the video below, you can listen to the interview that Dr. Tirgan conducted with the patient whose keloids are depicted in above photographs with focus on the history of this gentleman's keloid and his past experience with pain.