The case discussed here first came to see Dr. Tirgan in April 2014. At that time, she was 19 years old and had numerous acne-induced chest and shoulder keloids. By then, she had received several injections of steroids as well and laser treatments to all her keloids. The image below depicts the appearance of the keloids at presentation in April 2014.
Acne is a common cause of multi-focal chest keloids in young caucasian patients. Controlling acne is the most important aspect of medical care for these patients. Each new acne spot may transform into a new keloid lesion.
Furthermore, the safety of the keloid treatments that are offered to these patients must be taken into consideration in the long term planning for these patients. Most keloid patients, especially those who present like this case, will need long term and ongoing treatments. Repeated treatments with our most basic methods, such as steroid injections may lead to significant side effects, as the drugs used do have a cumulative effect.
This patient was advised to be treated with very low dose steroid injections, but on a regular basis. Fortunately, her keloids did respond well to this treatment and gradually improved. The images shown below show her gradual improvements.
One year later - July 2015
Two years later - April 2016
Six years later - June 2020
This case represents the importance of proper treatment planning in the management of keloid patients. To read more on the importance of treatment planning and strategy for the treatment of keloids, please click on the link.