Question: My daughter has a few keloid scars on her hands and her face that she’s very embarrassed about. Is there anything that can be done to lessen their appearance?

Answer: Keloid scars can be extremely difficult in certain patients and, therefore, I would have to evaluate your daughter to decide what the best treatment option would be.  If the scars are relatively new, then injection of dilute steroid solution into the keloid can oftentimes greatly reduce the thickness and firmness of the resulting scar tissue.  If these are old, then we would want to have a conversation about the risks and benefits of resecting these since, in a small percentage of patients, you can actually end up with keloids that are worse when you are actually trying to make them look better.

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Question: What scar revision techniques are best for children?

Answer: In the far majority of cases, unless the scar is actually creating tension or tethering or pulling on some area of the face, I always recommend that patients avoid any sort of scar revision while they are still children simply because, more than likely as they continue to grow, the scar is going to widen and ultimately need another revision once they stop growing. Otherwise, if some sort of a scar revision procedure is necessary in a child, the techniques are virtually identical as to those in an adult.

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Question: I have some keloid scarring on my ears from piercing. Can these be removed and how can I prevent them from coming back in the future?

Answer: Keloid scars from ear piercings can definitely be removed, but the injury from the removal can then cause new keloids to form creating a bit of a vicious cycle. In my personal experience, the far majority of my patients can benefit from a small amount of steroid injected into the scar about a month or two after the removal of the keloid and this will typically prevent the keloid from recurring. Some patients require multiple injections and a very small number actually have recurrence of their keloid even after the removal. A way to prevent the keloid is obviously first not getting your ear pierced but, even after getting the keloid removed and having a successful outcome, I would highly recommend that you not repierce the ears but instead just wear clip-on earrings. Many surgeons also feel that a small pressure earring specifically designed for the treatment of earlobe keloids can be worn during the healing phase to further decrease the risk of the keloid recurring.

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Question: I am African-American and I have a tendency to form keloid scars. Is it possible for me to get a nose job without keloid scarring? If the incisions are made on the inside of the nose and keloid scars form there, what would happen?

Answer: It is interesting that even in African-American patients that form keloids on other body parts, they tend not to form keloids on their nose and, certainly, I have never heard of keloids forming on the inside of the nose from incisions placed there during a rhinoplasty. If for some reason this would happen, most keloids are successfully controlled with repeated periodic injections of a steroid solution and it would be highly unlikely that these would grow to the point where they would become an issue with either the cosmetic result or the nasal airway.

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Question: WI have keloid scars from my facelift three years ago. Can they be fixed?

Answer: Yes, keloid scars from a facelift can definitely be fixed but, if it has been three years, this will usually involve a resection of the keloid scars and then careful approximation of sutures and then very close followup to try to prevent these keloids from recurring, which they typically try to. Followup includes injections of dilute steroid solution into the scar to help prevent the keloids from forming or, at the very least, minimizing the size of the keloid.

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