Keloids are usually seen around the earlobe piercing in individuals with genetic predisposition towards keloid formation.
Keloid is an abnormal scar that is hard, raised and spreads beyond the original boundaries of a wound. Asians and African Americans are more likely to get keloids. Keloids are notorious for recurrence in the earlobe area.
The initial step in treatment involves detailed counseling of the patient to achieve realistic expectations. The initial results of surgical removal of a keloid and earlobe reconstruction are excellent but the keloid can recur as late as two years after the initial surgery.
To avoid a recurrence many treatment options have been adopted. Some of the common methods include periodic steroid injections, silicon sheet application, pressure therapy like specially designed pressure clip on ear rings, frequent massage, 5-Flurouracil injections, interferon injections, and as a last resort radiation therapy.
My Approach: I like to excise the keloid and start injections of kenalog two weeks after surgery. I typically use 5mg every 3 months for a period of 5 years. Once a better treatment method is achieved I might switch over but for now there are no good options available. Using this method the likelihood of a recurrence is significantly reduced because most recurrences show up in the first two years.
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