Question: Is it possible to get rid of keloid scars? How do you prevent them from occurring again?

Answer: Keloid scars can be a very difficult thing to completely get rid of, but if your keloid is relatively new we can consider injections of steroid into the keloid to make it shrink, but if it has been present for an extended period of time then we would have to surgically resect the keloid and then start over following the area very closely so that steroid injections can be placed at the very earliest sign of keloid recurrence in hopes of preventing it from coming back.  Even with this regimen, there is still a significant risk of a keloid recurring, and I always discuss with my keloid patients that there is actually a risk of making the keloid worse than it started though I have not personally seen this actually happen in anybody it, nonetheless, is a very small risk.  

Question: What is the best treatment for keloid scarring, steroids, surgery, or some other procedure?

Answer: I am not sure that anyone can honestly say what the best procedure for keloid scarring is, but if the keloid scarring is early, I feel that injections of steroid is the most appropriate way to prevent the keloid scar from getting larger and in most cases we can even shrink the early keloid scar so that it ultimately becomes soft and inconspicuous. If the keloid scar is on the earlobe we can also add a small pressure earring that can assist in preventing the keloid scar from forming or getting bigger. Other adjunctive measures, such as silicone sheeting or silicone gel, as well as aggressive massage can also help, but the injection of steroids is really the mainstay treatment for uncontrolled keloids. As a last ditch measure, in extreme circumstances, external radiation can actually be used for keloid scars.

Question: I am in my 20s and have exceptionally terrible acne scarring from my teen years. Will a scar revision procedure eliminate or help to reduce their appearance?

Answer: I would have to personally evaluate your acne scarring to determine what procedure would be best for you, but for certain individuals a scar revision surgery would be appropriate if the acne scarring is exceptionally deep. This will only improve the area so that other adjunctive procedures, such as ProFractional laser resurfacing can be used to further improve the appearance of the acne scarring. Most of my patients have acne scarring that is not significant to warrant any sort of surgical intervention and therefore most of my patients we simply treat with the ProFractional laser, spacing treatments about a month apart and performing a series of 3 treatments. We allow this to then heal and the far majority of patients get a very significant improvement in their acne scarring, though I do caution patients that they cannot expect the acne scarring to be completely gone, but rather our end goal is a significant improvement of somewhere between 50% and 80%. If they would be happy with this, then more than likely they will be extremely happy with the results that we can achieve.