Monday, July 25, 2011

Keloid Treatment With Laser & Kenocort (Triamcinolone) Injections

Disclaimer: Results may vary from person to person. Please come for a consultation with our doctor for specific advise.

What is a keloid?

Keloids, sometimes referred to as a keloid scar, is a tough heaped-up scar that rises quite abruptly above the rest of the skin. It usually has a smooth top and a pinkish, reddish or maroon color. Keloids are irregularly shaped and tend to enlarge progressively. Unlike scars, keloids do not subside over time.

 Keloid scars are quite common after BCG injection

What is the difference between a keloid and a hypertrophic scar?

After the skin is injured, the healing process usually leaves a flat scar. Sometimes the scar is hypertrophic, or thickened, but confined to the margin of the wound. Hypertrophic scars tend to be redder and may subside by themselves (a process which can take one year or more). Treatment such as injections of cortisone (steroids) can speed this process.

Keloids, by contrast, may start some time after the injury and extend beyond the wound site. This tendency to migrate into surrounding areas that weren't injured to begin with distinguishes keloids from hypertrophic scars. Keloids typically appear following surgery or injury, but they can also appear spontaneously or as a result of some slight inflammation, such as an pimple on the chest (even one that wasn't scratched). Other minor injuries that can trigger keloids are burns and piercings. BCG injections can also give rise to keloids.

What are the signs and symptoms of keloids?

Keloids are raised and look shiny and dome-shaped, ranging in color from pink to red. Some keloids become large and unsightly. Aside from causing potential cosmetic problems, these scars tend to be itchy or even painful to touch.

What is the cause of keloids?

Doctors do not understand exactly why keloids form in certain people or situations and not in others. Changes in the cellular signals that control growth and proliferation may be related to the process of keloid formation, but these changes have not yet been characterized scientifically. You may have a genetic tendency to form keloids if you are prone to it.


Keloids develop most often on the chest, back, shoulders, and earlobes. They rarely develop on the face (with the exception of the jawline).

Which people are most susceptible to keloids?
Keloids are equally common in women and men, although at least in times past more women developed them because of a greater degree of earlobe and body piercing among women. Keloids are less common in children and the elderly. Although people with darker skin are more likely to develop them, keloids can occur in people of all skin types. In some cases, the tendency to form keloids seems to run in families. Asians are more prone to keloids than Caucasians.

In which area of the body are keloids most likely to appear?

Keloids develop most often on the chest, back, shoulders, and earlobes. They rarely develop on the face (with the exception of the jawline).

Is keloid prevention possible?

The best way to deal with a keloid is not to get one. A person who has had a keloid should not undergo elective skin surgeries or procedures such as ear lobe or body piercing. When it comes to keloids, prevention is crucial, because keloids are not easy to treat.

Keloids, by contrast, may start some time after the injury and extend beyond the wound site.

What are the treatments for keloids?

The methods available to treat keloids are:
  • Kenocort (triamcinolone) injections: These are safe and not very painful. Injections are usually given once every 4 weeks until the keloid is flat. The injection is mixed with a local anesthetic medicine called lidocaine to make it numb and less painful to inject. We charge RM100 per session for each small keloid (lesser than 3cm). It costs RM180 per session for large keloids (3cm or bigger). You may need 3 or 4 sessions to make it more flat. Some people may need even more injections, depending on their genetics, how well the respond to the injections and the size of the keloid. The injections may cause redness, swelling or sometimes scabbing for a few days. Kenocort injections will make the keloid flat, but it cannot remove the colour of the keloid. The colour can be removed using a Candela laser.
  • Laser:  Mediviron UOA Clinic uses Candela laser to make keloids look less red by reducing its vascularity. We use the spider vein removal handpiece on the Candela machine as the red or pinkish colour is due to the colour from tiny veins. The laser is safe, and has minimal redness, swelling or scabbing You may immediately return to work or your daily activities after the laser. We charge RM1000 per session of laser to do all the keloids. For best results, you need 6 sessions to improve the colour of the keloid. You can have a session once every 4 weeks. We can perform the laser for you when your keloid has become smaller and flatter after several sessions of Kenocort injection.
  • Surgery: This is risky, because cutting a keloid can trigger the formation of a similar or even larger keloid.We do not perform keloid surgery in our clinic as this is not a good treatment option.
  • Silicone sheets: This involves sticking on a sheet of silicone gel on the affected area for several hours a day for months or years, which is hard to sustain.. A well known brand is called Cicacare. Your keloid will improve about 10% after few months, so the results are not very good.
  • Topical Ointments/ Oils/ Vitamin E cream/ Silicon Gel Sheet: There are many creams in the market which claim to improve keloid scar appearance. However, all of them do not work well and take a very long time for improvements. You would probably only see 10% improvements after few months of using the creams / oils/ ointments diligently, therefore it is not a very good treatment option.

In conclusion, the best treatment is having Kenocort injections to make the keloid flat and laser to make it less red or vascular. We can perform the laser for you when your keloid has become flatter after several sessions of Kenocort injection. You may need at least 2 -3 sessions of Kenocort injections and 6 sessions of laser.

66 comments:

  1. I have >20 keloid scars all over the body. Do you charge RM450 also for one laser session?

    ReplyDelete
  2. Yes. It cost RM450 per session even if you have more than 20 keloid scars. Sign up for 7 sessions and get 3 sessions free.

    ReplyDelete
  3. i have a big keloid, on my arm (from BCG, then surgery to remove it, then it came back bigger), and a few other really small keloids on my body.. im sure the amount of sessions differ depending on the keloid size and progress.. roughly how many sessions of injections and laser treatments would i need?

    ReplyDelete
  4. Mediviron UOA Aesthetic ClinicNovember 17, 2011 at 5:35 PM

    Small keloids (less than 3mm) may need 2 sessions of Kenocort injections, or at most 3 sessions. Large keloids may require 3-4 sessions.

    For all keloids, 10 sessions of lasers would be needed to improve 60-80% of the colour. Each session is spaced 2 weeks apart.

    ReplyDelete
  5. i have a huge keloid scar from BCG too. i never do any surgery or injection. but mine is very itchy, can your treatment stop the itchiness?

    ReplyDelete
  6. The keloid injection will definitely reduce the itchiness. This is because the steroid medicine has anti-inflammatory properties. It will also help to reduce the size and make it smaller. Please call us at 03-21635699/98 during office hours to visit us for your free consultation.

    ReplyDelete
  7. Hi, i have tried the injections for few months on my arm and chest. Though the arm one seem to get flattened, it return back to the original size...while for chest, the injection only made it even abit bigger. I stopped the injections thgh because the injection to the chest was very very painful. Can you advice what should i do?

    ReplyDelete
  8. Hi, keloids will surely increase in size after the injections. There is no cure for keloids. The injections only help to control it. Once the keloid is flatter, you can stop injecting. The keloid will grow back to its original size or even bigger than before injection after some time. When you see that the keloid is starting to grow in size again or starting to itch, you should quickly get another injection to control the keloid. Keloid treatment is a lifelong process because the keloids are caused by genetics and we cannot cure or change your genetics.

    For pain relief, we add lidocaine which is a numbing medicine to make it less painful. You can also take painkiller tablets before injection, apply numbing cream or ice before injection to make it more comfortable.

    ReplyDelete
  9. hello, i have keloid in my legs about 1 inch.. it can possibly disappear or removed? in what treatment? and how much will it spend? thanks

    ReplyDelete
  10. For keloids, we treat with Kenocort (active ingredient Triamcinolone) injections. It cost RM100 per injection session for keloid less than 3 cm. We charge RM180 per session for keloid longer than 3cm. You might need 2-3 sessions, done once every 2 weeks to make it flat. The injection has minimal discomfort because it is mixed with a numbing anesthetic medicine. We use a very small needle so it is comfortable. There is some mild redness or bruising after the injection. There is no pain or swelling after the injection. After 2-3 sessions, the keloid will become flat. However, the colour will still be reddish or dark. The injection cannot make the colour turn back to normal.

    To make the colour of the keloid turn back to normal skin colour, we would need to do laser.

    We can remove dark keloid scars by using laser. We have the Medlite C6 laser, which is the best laser in the market today for pigmentation removal. We can inject the Kenocort and do the laser on the same day.

    We charge RM450 per session of Medlite C6 laser to laser all your keloid scars. Do 7 times and get 3 time free. You would need 10 sessions to see up to 60 to 80% improvement in the colour of the keloid.

    For the first session, you need to spend about 1 hour in our clinic for a free consultation and skin examination, explanation about the procedure, doing the actual laser, given post laser care advice and setting your next appointment session. The actual laser only takes 5 minutes to do. It is totally painless and there is no side effects such as redness, swelling et cetera. You can immediately go back to work and do your usual activities after the laser. You need to wait 2 weeks in between laser sessions.

    The Medlite C6 is the latest laser technology in the market and is safe for all skin types, unlike older technology such as IPL or earlier generation lasers which may cause burns or redness in people with darker skin.

    Feel free to read about laser procedure, before and after photos, side effects, price and other details on our website:
    http://www.medivironuoa.com/search/label/Laser

    Do call us at 60-3-21635698/ 99 if you have any queries or wish to make an appointment, or email us at chenth@streamyx.com . We are open Monday to Saturday 8.30am to 6pm. We are closed on Sundays.

    ReplyDelete
  11. hi. are they any differences between cortisone injections and kenocort injections? which one is giving better result? i've heard that most injections are administered monthly instead of per two weeks. thanks.

    ReplyDelete
    Replies
    1. Mediviron UOA Aesthetic ClinicMar 2, 2012 08:34 PM

      Cortisone, Triamcinolone and Kenocort all mean the same thing. Triamcinolone is the ingredient of the injection. Triamcinolone is a type of cortisone or steroid. There are many brands of Triamcinolone in the market such as Kenocort, Shincort and many others. Kenocort is one of the many brands of Triamcinolone.

      We administer the injections monthly or sometimes even every 6 weeks, depending on the keloid.

      Delete
  12. hi. i have more than 10 keloids. do you charge RM100/RM180 per session or per keloid?

    ReplyDelete
    Replies
    1. Hi, we charge RM100 per session for each keloid less than 3cm. We charge RM180 per session for each keloid more than 3cm. For example, if you have 10 keloids less than 3cm, it costs RM1000 per session to treat all 10 keloids. For clients with numerous keloids such as yourself, we will offer you 10% discount from the total price.

      Delete
  13. for how long will it take to cure or maintain keloids? is there other way like surgeory etc...?

    ReplyDelete
    Replies
    1. Hi, surgery is not advisable as there is a very high chance the keloid will come back and become even bigger than before doing any surgery.

      There is no cure for keloids. Some people will need life long steroid injection for keloids as there is no cure. Some people only need a few sessions (perhaps 3-5 sessions) of steroid injection and the keloid becomes flatter for many years. So results vary from person to person.

      Delete
  14. after having done with course will it be normal? or do we have to go for our lifetime process?? please help me regarding this.

    ReplyDelete
    Replies
    1. Even after doing the treatment, the keloid will become flatter but not completely gone. The area will still have a different colour or texture. After laser, it will look better but the results would still not be perfect.

      For many people, the keloid treatment is a lifelong process. This is because there is no cure for keloids. We can control it temporarily by giving steroid injections but there is a possibility after a few weeks/ months/ years, the keloid gets bigger again and you will require more injections.

      Delete
  15. my daughter (10months+) got keloid because of chicken pox. There are 4 small keloids. do you suggest to give keloid injection to her? Otherwise, do you have other recommendation?

    ReplyDelete
    Replies
    1. Hi! Your baby might be having a keloid or possibly a hypertrophic scar due to chicken pox. The treatment is the same for keloid and hypertrophic scar, which is Triamcinolone injection. For babies, we will use a very low dose of the medicine to be safe. So your baby may need more than one injection session as the dose of medicine used is low.

      For keloids or hypertrophic scar , we treat with Kenocort (active ingredient Triamcinolone) injections. It cost RM100 per injection session for keloid or hypertrophic scar less than 3 cm. We charge RM180 per session for keloid or hypertrophic scar longer than 3cm. You can have an injection session once every 4 weeks to make it flatter. The injection has minimal discomfort because it is mixed with a numbing anesthetic medicine. We use a very small needle so it is comfortable. There can be some mild redness, swelling or bruising after the injection which goes off in a few days.

      Most clients need 2-3 sessions and the keloid or hypertrophic scar will become flatter. Some clients may need more sessions (sometimes 6 or more sessions) to make it flatter for keloids. For hypertrophic scar, rarely will they need so many sessions. We are unable to know in advance how many sessions your baby will need because different people respond differently to treatment.

      Delete
  16. Hi,

    I have a keloid from piercing my ear and it seems to be growing. I had a couple of kortisone injections but instead of thinking it would be reduced, the size is now growing.

    How much would it cost to have it removed?

    I am covered under Allianz Insurance (MEDICLINIC) given by my company. Will this surgery covered? Should I get a referral letter from my GP?

    Your kind reply is very much appreciated.

    -nat-

    ReplyDelete
    Replies
    1. Hi Nat, we are a panel for Mediclinic but cortisone injection/ keloid removal surgery is not covered. All insurance companies do not cover for aesthetic procedures, sorry. We do not offer keloid removal surgery. We also use cortisone injection. You need to inject it once a month until it shrinks in size. It will remain small in size for a few weeks/ months/ years. When it starts to grow back in size, you must quickly get it injected again. It is difficult to cure keloids.

      Delete
  17. Hi ive had the lapband done and hav very small keloids at all my 5 incisions. Im african american so theu are a dark brown on my stomach. Anything i can do?

    ReplyDelete
    Replies
    1. Hi, you can do Triamcinolon injection for your lapband keloids. It is suitable for African Americans as well.

      We are open Mon-Sat 8.30am to 6pm. We are closed on Sundays and Public Holidays.

      We are located at Wisma UOA, Jalan Pinang, Kuala Lumpur, which is just opposite Aquaria KLCC and KL Convention Centre.

      Our clinic address and map is on our website:
      http://www.medivironuoa.com/2010/05/locate-us-on-google-maps.html

      Please feel free to call us at our clinic at +60-3-21635699/ 98 or +60-17-2163569 during office hours if you have any questions or would like to make an appointment. We would be glad to explain in detail regarding the procedure, answer all your queries and give you the best possible service during your free consultation.

      Delete
  18. Hi,

    I poured compound of phenol & salicylic acid on a flat mole on my finger. It burned the mole and the skin a bit deep until it formed a crate. After several days, the skin grew again and formed scab. Then after the scab was gone, the skin where the mole was there before now grew into small red lump.

    See these pictures of the red lump:
    http://imageshack.us/photo/my-images/405/viewfromabove.jpg/
    http://imageshack.us/photo/my-images/28/viewfromside.jpg/


    The red lump in normal days was not itchy or painful at all. But one day, I pricked it with my nail a bit and the lump swelled and it become itchy and painful.

    The doctor gave me prescription: salicylic acid + madecassol oint. He couldn't gave an injection shot because he said the lump is too small.

    The prescription cured the swell, but the lump is still there. I want to flat it out. I'm afraid that lump will get hurt again.

    My questions are:
    -Is the red lump on my finger is really keloid or hypertrophic scar?
    -Could triamcinolone injection shot to be applied into a small keloid (like mine) ?
    -Do you think that lump on my finger can be cured (become flat again) ?


    Regards,
    Rudy, Jakarta

    ReplyDelete
    Replies
    1. Hi! It is a hypertrophic scar. Keloids are much bigger than the original lesion. Yes, you can inject triamcinolone for a small scar like yours. Our doctors are very experienced for injecting even such small scars. It will become flatter after the injection.

      Delete
  19. hi,

    I have a large keloid (about 34 degree burn scar)on the back, hands and feet from a fire last year and I am still a student.

    my question are;
    1. will I get a discount on treatment.
    2. It costs still RM180 per session for Kenocort injection and RM600 per session for laser treatment.
    3. How long it will take for treat a large burn keloid like mine

    --sean,SWK--

    ReplyDelete
    Replies
    1. Hi Sean,

      We offer 10% discount for student. For the large keloid, we advise you to see our doctors to discuss the price. Results may vary from person to person. Some may take longer, some may take shorter. May we have your contact number so the nurse can call you to give you more info. You can email it to mediviron.uoa@gmail.com

      Delete
  20. Hi. My name is luz. I have a 10 year old keloid scar on my chest. The stitches are also a little noticeable but are not pink like the keloid itself. I know the laser will help with the keloid color, but do you think it will take the stitches marks away? Also can I have the injections and laser at the same time? My keloid s almost flat but I might need maybe just one more injection... I need to know if it could be done at the same time because I have an important event coming up and don't have much time. Thank you for your help. Luz

    ReplyDelete
    Replies
    1. Hi Iuz.
      Laser will make the stitches mark less noticeable, but sometime more than 1 session is needed in average 5-7 sessions. You can have laser & injection at the same time.
      May I have your email and contact number so our nurse can contact you to provide more information. You can email it to mediviron.uoa@gmail.com

      Delete
  21. i have a surgery done vertically on my abdominal area and the keloids appears only on the top part of the scar, approximately 7cm, which is unsightly.
    So, how many injections would it requires to flatten the keloid and how much would it costs me?

    ReplyDelete
    Replies
    1. Hi
      May I have your email address and contact number so we can contact you to provide more information in detail. Please email it to mediviron.uoa@gmail.com
      Thank you.

      Delete
  22. Hi , iam a 26 AA female; I have about 50 keloids on my body ranging from , my chest, back, legs, private area , and butt. I also have bad stretch marks , please advise !

    ReplyDelete
    Replies
    1. Hi.
      Kindly send your email address and contact number to
      E: mediviron.uoa@gmail.com
      so we can contact you to provide more info.
      Thank you.

      Delete
  23. Hi, i do have keloid problem. Recently i noticed there is a new treatment for keloid, called 'Cryotherapy'. Pls advice the differences and effectiveness between cryotherapy and kenocort injections?

    ReplyDelete
    Replies
    1. Hi.
      Cryotherapy is not very effective for keloid. Cryo is better for skin Tag removal. We also have cryo in our clinic but do not recommend it for keloid. Keloid need kenocort steroid injection for best results.
      Kindly email your contact number to our provided email so our beautician can contact you easily to explain in detail. Thank you.

      E: mediviron.uoa@gmail.com

      Delete
  24. Dear Dr,

    I have a 1.5 cm keloid behind my ear, not because of piercing but when I was 14 years old, it's been cutted a bit when I cut my hair. Now I am 35 years old and the keloid has grown to 1.5 cm..

    What are your suggestion to make it gone from my ear and how much overall cost? Thank you Dr...

    Regards

    ReplyDelete
    Replies
    1. Hi!
      For keloids, we treat with Kenocort (active ingredient Triamcinolone) injections. It cost RM100 per injection session for keloid less than 3 cm. We charge RM180 per session for keloid longer than 3cm. You can have an injection session once every 4 weeks to make it flatter. The injection has minimal discomfort because it is mixed with a numbing anesthetic medicine. We use a very small needle so it is comfortable. There can be some mild redness, swelling or bruising after the injection which goes off in a few days.
      May I have your contact number and email address so our nurse/beautician can contact you to explain in detail. Kindly email it to E: mediviron.uoa@gmail.com
      Thank you :)

      Delete
  25. Hi !


    I have a keloid on my chest and on my face. is it possible if go for cyrotherapy treatment? i already went for injection and the keloid still the same.

    regards,

    ReplyDelete
  26. I have a keloid on my chest. It is a small keloid. I have taken more than 10 Kenocort (Triamcinolone) Injections. The keloid is still there at almost the same size. Should I continue to take the keloid injections?? what options are left with me

    ReplyDelete
    Replies
    1. Hi Dhiraj.
      You will need higher dose of triamcinolone injection. Triamcinolone comes in many different doses. Our clinic uses the highest dose for better results.

      Please feel free to call us at our clinic +60-3-2163 5699/ 98 or +60-17-2163 569 during office hours if you have any questions or would like to make an appointment. We would be glad to explain in detail regarding the procedure, answer all your queries and give you the best possible service during your free consultation. We will try our best to get you an appointment time of your choice :)

      Delete
  27. Hi,

    I have a very large keloid scar (over 6" long after aortic valve surgery four years ago). Can this procedure be done safely if taking warfain blood thinner ? target INR is 2.5.

    ReplyDelete
    Replies
    1. Hi.

      Yes , can be done but it might have bruising which will take a few days to go off. Kindly fill up our 'Contact Form' with your contact details so we can easily to contact you to schedule your appointment.

      Delete
  28. Would you do cryotheraphy on keloids if requested...i would like to freeze few small keloids on my chests. How much does this cost?

    ReplyDelete
    Replies
    1. We don't do cryotherapy for keloid due to its many side effects. These include:
      Swelling and blistering may occur right after cryotherapy. Temporary darkening of the skin may happen in the months after the procedure. Hypopigmentation can occur and may be permanent, especially on patients with darker skin tones

      Do come and see us for a complimentary consultation.

      Delete
  29. Hi! I had steroid injection and a laser treatment about 10 weeks ago on a keloid scar on my foot from a burn accident 6 years ago. My keloid scars are still badly bruised from the injection and laser. Is that normal? I've also noticed my skin became very fragile. I easily get cuts from wearing shoes and it hurts. Honestly, I regret receiving this treatment because my scars look better before.

    ReplyDelete
    Replies
    1. You should come for a consultation so that Dr can recommend what is suitable treatment. Our Consultation is free on Monday to Thursday.

      Delete
  30. Hi,I have a keloid from my accident about 6 month ago on my solder n hand it less than 3 cm,how many injection do u think I need to get it flat?does it work?or the keloid will be back some day still?how much it cost?thx

    ReplyDelete
    Replies
    1. Hi it cost RM100. How many injections depends on the thickness as well. It can be one or two. The keloid will gradually go down but there are some cases where they reoccur and we can still treat again.

      Delete
  31. What is the cost of cortisone injection for my knee pain...thks

    ReplyDelete
    Replies
    1. Hi there, together with Dr consultation it is RM20. We have some good ointments that can help relieve the pain. Please come and consult with doctor.

      Delete
  32. What are the long term side effects of the cortisone(or whatever you termed it) injection? I have taken 3 injections more than 7 years ago for my bcg keloid, and now feeling the side effect from the steriod I guessed.My left hand now feels weak, numb, and not as strong as my right hand. Could it be due to the steroid?

    ReplyDelete
    Replies
    1. The steroid injection is only a small amount done once a month and the amt is small to cause any "serious" side effect. ANY side effect should come in less than a year NOT after 7 years!!

      Delete
  33. How about hyperthrophic scar? The doctor did excession on it and now left with straight scar, can u get rid of it using laser? And how much the price?

    ReplyDelete
    Replies
    1. Hi, at our clinic we use kenacort injections to treat hyperthrophic scars. After which we use laser to treat the discoloration (red/brown).

      Delete
  34. hi, can cartisone injection cure acne?

    ReplyDelete
    Replies
    1. Cortisone can be used to treat active acne.

      Delete
  35. how about children 8 &9 years old...can still do the laser treatment?if can...im interested.

    ReplyDelete
    Replies
    1. Hi, youngest patient we had was 2 months old. However please bring your child for a complimentary consultation with the doctor first.

      Delete
  36. Hi. I'm interested with the laser treatment that you have. But I'm pregnant in first trimester now. What would be your advice?

    ReplyDelete
    Replies
    1. Hi, may I know what is your concern? You can do laser during pregnancy, however please come for doctor consultation for proper assessment. Kindly email us at contactus@mediviron-uoa.com to set an appointment.

      Delete
  37. i have a keloid i need to be treated immediately so when am i to do it.... and where am i to locate your clinic

    ReplyDelete
    Replies
    1. Hi Larry, keloids can only be removed after a few sessions of kenacort injections. Once it is flat you will need to do laser to even out the colour. There is no immediate cure for keloids. We are in Jalan Pinang opposite KL Convention Centre. http://www.medivironuoa.com/p/our-location.html

      Delete
  38. Hi, i have a injection of steroid for my scar...do laser treatment only can be done once the scar is completely flattened? How long mamy weeks laser can be take after steroid injection? And hw much the price of laser?

    ReplyDelete
    Replies
    1. Hi, Please come for complimentary doctor consultation for a discussion. You can make appointment by email to contactus@mediviron-uoa.com

      Delete