Q I have had acne keloids since my teens (I am now 20) and they do not seem
to be healing despite professional help. The keloids resurface even after several steroid injections. They appear on my chest in clusters, on the back and the jawline.
The injections did put off those on the back but the ones along my jaw and on my chest keep recurring. Are there alternatives to the steroid injections which can be very painful and ineffective? Is there surgery that can remove keloids and the awful discolouration left behind after they flatten? Are these procedures costly?
A Acne keloids can be treated on a daily basis using silicone gels or gel sheets. These are best combined with regular steroid injections. Be patient with the injections as they typically take months to achieve a good outcome.
At each visit to the doctor, the dose of the steroid used for injections is titrated, based on the response to the previous injection and side effects such as thinning and formation of fine blood vessels (telangiectasias).
When a keloid flattens, you can consider vascular laser treatment to lighten the red colour. If a keloid is bulky, it can be removed using surgery or ablative laser. But removing it is only a temporary solution. You need to continue seeing the doctor regularly for steroid injections to prevent fresh keloids from forming.
Dr Derrick Aw
Consultant, University Dermatology Clinic, NUH