Keloidal scarring is different from hypertrophic scars. Keloid Scarring is one of the most frustrating clinical problems in plastic and reconstructive surgery. Keloids form after dermal injury with an exuberant an indefinite production of collagen. It is a type of face scar. It has been shown that keloid and hypertrophic scars are derived from fibroblasts producing increased amounts of collagen per cell compared with normal fibroblasts. They tend to occur in highly pigmented individuals with a familial tendency. Keloid formation etiology has numerous theories: (a) altered growth factor regulator, (b) abherrant collagen (c) genetics, (d) dysfunction, (e) sebum reaction and, (f) altered regional mechanics. No single hypothesis adequately explains keloid formation. The various treatments for keloid underscore how little are understood about this disease process.
The present standard of care is kenalog injection on a regular basis with and without surgery and radiation therapy. Recently a patent was obtained for a new product that has proven to be effective in most cases.
The product (trademark name Keloil) is composed of a slow absorbing material with various concentrations of kenalog that is strategically placed in the wound after excision. Variation in placement in the wound is directly related to the wound size and length. An upgrade of the product has been done in an effort to improve efficacy to the original product used in such strategic locations (e.g. anterior facial region and other areas of tension). This new product includes 5 FU and kenalog at concentration suggested by Asilian, Ali et al. (*New combination of Triamcinolone, 5-fu and pulsed –dye laser for treatment of keloid and Hypertrophic scar. Dept of dermatology, Isfahan University of Medical Sciences, Isfahan, Iran.
Patients with this disorder often experience major physical (deformities, restricted range of motion, pain, and, pruiritus) and psychological problems secondary to cosmetic concerns.