(Updated July 21, 2021)
R6 Keloid Cream is a compounded cream that contains six different pharmaceutical ingredients. Dr. Tirgan has used both R5 (with five ingredients) and R6 (with six ingredients) creams on several of his patients. The responses in some patients, roughly 20% of patients have been dramatic.
The images below depict the before and after of the appearance of a large keloid that had affected the right arm/elbow area of one of our patients. The image on the left was taken by Dr. Tirgan in his office on April 2014. The image on the right was taken by the patient in July 2018. All this patient had done was to apply the R5 Cream to the keloid for three years. This dramatic response encouraged Dr. Tirgan to prescribe the cream to many more of his patients.
Complete response in a tumoral pubic keloid.
The images below were taken by one of Dr. Tirgan's patients who had applied the cream to her pubic keloid for several months. After one year of use, there was almost complete resolution of her tumoral pubic keloid. Images shown here were supplied by the patient who has meticulously documented the course of her own treatment.
Tumoral pubic keloid before and after treatment with R5 cream.
Ongoing Response in a Chest Keloid
The images below were submitted by another patient who continues to use the R6 cream to her chest keloids for several months. Here is the e mail that she sent to me on July 19, 2021.
Hello Dr. Tirgan,
I wanted to provide another update with pictures on my chest keloids using the R6 cream, which I have just re-ordered again. I have been using it since June 2020 and I can definitely tell some improvements. See attached for the progression pictures with dates. I believe the cream is continuing to help with the bulky areas as well as reduce the redness to some of the areas that were less bulky, or more flat, to begin with. The keloids also feel a bit more soft in some areas. I very rarely get shooting pains through them anymore. Occasionally, they will still itch, but not nearly to the extreme as they did before starting the cream. They are still sensitive to the touch and it is hard to tell if the cream has improved that at all. However looking at the comparison pictures today I am happy with the results.
Effect of R6 cream on Chest Keloids.
Excellent pain control - chest keloid
The third patient is a 59-year-old African American female, who developed keloids on her chest following surgery. The lesions (shown in the image below on the left side) were causing significant pain and discomfort, to the point that this patient could not even touch them. Within a few days of applying the R5 cream, the patient noticed a significant reduction in her keloid pain. The image on the right was taken 10 days after she started using the R5 cream. The surface of the keloid shows dark mottling and the keloid appears to be less inflamed. She is now able to press against the keloid and feels no discomfort. Although it is too soon to assess the response to the cream, the patient is encouraged to continue the treatment.
Dr. Tirgan recently send a survey to all his patients who have used either R5 or R6 creams. 36 patients responded to the survey questions. The results of this survey are depicted in graphs below. In summary half the patients found the creams to be helpful. Thirty percent saw improvement in appearance of their keloids and 11% reported significant improvement in their keloids.
Who Should NOT take R5 or R6 creams
1- Anyone with a history of drug allergy (to any drug). We had one patient who had a known past allergy to NSAIDs (non-steroidal anti-inflammatory drugs) who used the R6 cream and had an allergic skin reaction. She was advised to stop using the cream.
Where are we with R5 and R6 creams?
As of December 24, 2019, Dr. Tirgan has prescribed this cream to over 200 of his patients. Most patients have been on the cream for approximately few months. About 20% of patients using the cream have reported improvement in the appearance of their keloids, but what is encouraging is that the cream has clear anti-itch activity in about 66% patients who have itching and pain. For those who have been on the cream, please continue applying it to your keloid twice per day, unless you notice a problem. It appears that the cream must be taken for at least several months to achieve results. The regression seen in the tumoral keloids took over a year in the patients described above.
Positive comments about the cream
1-I started using the R5 cream on August 30th, 2018 and almost two months later I can honestly say that the keloid has improved. It has become flatter, less red and also the symptoms of pain and itchiness are still present but improved. I will continue to use the cream as long as Dr. Tirgan agrees and hopefully, it will become skin leveled (TC).
2-Keloids have decreased in size slightly each day but is noticeable (JJ).
3-The product has softened my keloids and has reduced some redness. The product has also made a few keloids smaller (EC).
4-Less itching and burning. Some scars appear lighter and flatter (DS).
5- I’ve had keloids are over 32 years. After applying the cream they are a bit softer and less “angry” although I must say that it is minimal yet I can notice it (CS).
6-Swelling and thickness is getting less and secretion has also decreased. Noticed slight improvement in itching and irritation (GP).
7-The itch has been reduced in all except the big one on my chest. The pain in my back has been less. The size of most of my keloids have been reduced. The smaller ones are most noticeably smaller. The big ones on my shoulders used to get very inflamed when it was time for another injection but they are not inflamed and appear to be getting smaller. I have not had or needed any injections since using the cream. I’ve been using the cream for about six weeks so far (PB).
8-Some of the areas that are already flat but slightly red now have a more natural appearance. The part of the keloid that remained after the cryotherapy and somewhat raised may be a bit flatter and no longer itches. The smaller of the two keloid areas appears to show more improvement. Applying the cream to the very small keloid has resulted in flattening of the raised area (AC).
9-So far so good! I'm glad I purchased the product (RA).
10-It helps with the pain I use to feel, it has worked better in some areas than other.
11-Day 1 after using R5 cream I noticed a difference right away. The keloids were a lot smaller, they also did not feel as bumpy. The color of my keloids matched my skin pigmentation with the exception of some of the bigger keloids still being light pink. After about 2 1/2 weeks of using the R5 I notice that after I put the cream on, the bigger keloids are very flattened for about 8 hours then rise back up. The bigger and more noticeable/ bumpier keloids are having a harder time diminishing. Overall, I am highly satisfied with the progress my keloids have made in the short amount of time that I have been using the R5 cream (MG).
12-The cream had been working pretty good in my opinion. It feels like the keloid has gotten a lot smaller (AA).
13-I have noticed that the texture of the keloid has softened and the color is changing and is less red and irritated looking and it seems like the borders are slowly starting to shrink (DB).
Negative comments about the cream
Here are all the negative comments from our patients who have used the cream:
1- Dr. Tirgan has advised about 20 patients to stop using the cream.
2- Some patients felt irritation at the site of their keloids.
3- One patient with very small ear keloids noticed irritation and some swelling of the keloid lesions. She was advised to stop using the cream.
4- One patient with a known history of allergic reactions to NSAIDs had an allergic reaction to the cream and was advised not to use the cream anymore.
5- The rest who stopped taking the cream did so as they did not notice benefit from the cream.
What is most interesting is that in some patients who have multiple keloid lesions, some lesions respond to the cream, while other lesions do not. Dr. Tirgan is now following a handful of patients who are using the cream and also receiving standard treatment to the keloid lesions that do not respond to the cream.
Who can order the cream?
If you have not been a patient of Dr. Tirgan, it is best to have a tele-medicine consultation with Dr. Tirgan before you try the cream and to also remain under remote care of Dr. Tirgan while you are using the cream.
- Please contact DrTirgan@gmail.com with any question you may have or if you notice any problems.
- Dr. Tirgan will update this page as he gains more knowledge about the impact of R5/R6 creams.
How to use the cream?
- When you get the cream for the first time, apply a test dose of it to the back of your hand to make sure that you are not sensitive to any ingredients of the cream. If you notice any issues such as itching, burning, or redness of your skin, wash your hands with soap and water. Do not use the cream and contact Dr. Tirgan.
- If your skin test dose goes well, apply the cream to your keloid twice per day. Please clean your skin before applying the cream.
- Apply the cream only to the keloid area. Try to minimize the amount of the cream that goes on the normal skin.
- If the keloid is surrounded by a red margin, apply the cream to the red margin as well.
- When applying the cream to small facial keloids, use a Q-Tip and apply the cream only to the keloid tissue.
- Stop taking the cream if you notice any problems.
- Apply the cream for a minimum of TWO months unless you notice a problem.
- If you notice any degree of improvement, you should then continue the treatment.
- If you do not see any improvements at the end of two months, you can stop the treatment.
- Make sure you take pictures of your keloids before the start of treatment and on a regular basis (once a week) afterward in order to objectively assess the results.