Keloids are abnormal scars that extend beyond the original wound boundary, affecting individuals of all backgrounds but showing significantly higher prevalence in certain populations. These raised, firm nodules can cause pain, itching, and cosmetic concerns while demonstrating a strong tendency to recur after treatment.
Dr. Zitelli provides comprehensive keloid management throughout Cincinnati, offering evidence-based treatment options ranging from intralesional injections to combination therapies designed to reduce keloid size and prevent recurrence.
Not only provides excellent care but truly cares.
Understanding Keloids vs. Hypertrophic Scars
Keloids and hypertrophic scars represent different forms of abnormal wound healing requiring distinct diagnostic approaches and treatment strategies.
True Keloids
Pathological scars that grow beyond the original wound boundaries, extending into healthy surrounding skin with continuous growth potential and high recurrence rates
Hypertrophic Scars
Raised scars confined within the original wound margins that may regress spontaneously over time and typically respond better to treatment interventions
Spontaneous Keloids
Rare keloids that develop without significant preceding trauma, often occurring in predisposed individuals on high-tension areas of the body
Post-Traumatic Keloids
More common keloids developing after surgery, burns, piercings, acne, or other skin injuries, particularly in wounds healing by secondary intention
Dr. Zitelli’s Comprehensive Keloid Assessment
Accurate keloid diagnosis and treatment planning require understanding individual risk factors, keloid characteristics, and realistic treatment expectations. Dr. Zitelli’s systematic approach ensures appropriate therapy selection and optimal outcomes.
“Successful keloid management requires patience and often combination treatments. Understanding each patient’s specific risk factors and keloid characteristics helps us develop the most effective treatment plan while managing expectations,” explains Dr. Zitelli.
Clinical Evaluation and Risk Assessment
Keloid evaluation includes assessment of size, location, symptoms, and duration while identifying potential risk factors such as family history, skin type, and previous treatment responses. Dr. Zitelli evaluates keloid characteristics to distinguish them from other skin conditions.
Treatment Planning and Patient Education
Comprehensive keloid care involves discussing realistic treatment expectations, potential side effects, and the chronic nature of keloid management. Treatment plans are individualized based on keloid characteristics, patient preferences, and risk factors.
Evidence-Based Treatment Approaches
Modern keloid management offers multiple therapeutic modalities often used in combination to achieve optimal size reduction and prevent recurrence.
Intralesional Corticosteroids
First-line treatment using triamcinolone injections repeated every 4-6 weeks, providing anti-inflammatory effects and collagen reduction in most patients
Cryotherapy
Liquid nitrogen freeze-thaw cycles causing controlled tissue destruction, particularly effective for smaller keloids but may cause pigmentary changes in darker skin
Silicone Gel Therapy
Topical silicone sheets or gels worn 12-24 hours daily for months, providing mechanical pressure and hydration to improve scar appearance
Surgical Excision
Complete keloid removal followed immediately by adjuvant therapy such as radiation or steroid injections to prevent recurrence, reserved for appropriate cases
Advanced Treatment Considerations for Keloids
Certain keloids require specialized approaches or combination therapies to achieve optimal outcomes and minimize recurrence risk.
Combination Therapy Protocols
Many keloids respond best to combination treatments such as surgical excision followed by radiation therapy, or intralesional steroids combined with pressure therapy. Dr. Zitelli develops individualized protocols based on keloid characteristics and patient factors.
Large or Recurrent Keloids
Extensive keloids or those with previous treatment failures may require more aggressive approaches including surgical excision with post-operative radiation, multiple treatment modalities, or referral to specialized centers for advanced interventions.
Prevention Strategies
Keloid prevention represents the most effective management approach for individuals with known predisposition to abnormal scar formation.
Avoiding unnecessary procedures like cosmetic piercings or elective surgeries in keloid-prone individuals significantly reduces keloid development risk. When surgery is necessary, proper wound care, tension reduction, and early intervention with preventive treatments help minimize keloid formation.
Quality of Life and Psychological Impact
Keloids can significantly impact patients’ self-esteem, body image, and social functioning, particularly when located on visible areas like the face, neck, or hands.
The cosmetic disfigurement, associated symptoms like itching and pain, and potential for continued growth create ongoing psychological stress. Comprehensive keloid care addresses both physical treatment and emotional support for affected patients.
Treatment Monitoring and Long-term Management
Keloid treatment requires ongoing monitoring and long-term management strategies due to the chronic nature of these conditions and their tendency to recur.
Regular follow-up appointments allow for treatment response assessment, side effect monitoring, and therapy adjustments. Many patients require maintenance treatments or periodic interventions to maintain keloid control and prevent recurrence.
Frequently Asked Questions About Keloids
Keloid development involves genetic predisposition, with higher rates in individuals of African, Asian, and Hispanic descent, though the exact genetic mechanisms remain incompletely understood.
Unlike hypertrophic scars, true keloids rarely regress spontaneously and typically require active treatment to reduce size and prevent continued growth.
Keloid recurrence results from the underlying abnormal wound healing process that persists even after treatment, which is why combination therapies and adjuvant treatments are often necessary.
Keloids are benign growths that do not become cancerous, though they can cause significant cosmetic and functional problems requiring appropriate medical management.
Individuals prone to keloids should avoid unnecessary skin trauma, seek prompt wound care, and consider preventive treatments when surgery or procedures are necessary.
Board-Certified Dermatologist Serving Cincinnati, Ohio
Dr. Kristine Zitelli is a board-certified dermatologist serving the Cincinnati area, known for her expertise in treating a wide range of skin conditions. She completed her medical degree at Wright State University and dermatology residency at the University of Cincinnati, with additional advanced training at the UCSF Psoriasis and Skin Treatment Center. Her clinical focus includes thorough skin examinations, psoriasis, eczema, complex medical dermatology, surgical dermatology and cosmetic treatments using the latest technologies.
Dr. Zitelli has been named a “Top Doctor” in Cincinnati every year since 2016 as well as Cincinnati’s Top Dermatologist in 2020. She remains dedicated to educating the community about skin health and sun safety. Combining academic excellence, clinical research, and a compassionate approach, Dr. Zitelli delivers personalized, evidence-based care to every patient.
Effective Keloid Management in Cincinnati
Don’t let keloids affect your confidence and comfort. Dr. Zitelli’s comprehensive approach to keloid treatment combines proven therapies with individualized care, helping patients in Cincinnati and Montgomery achieve optimal scar reduction and prevention strategies. Schedule your keloid evaluation today to explore effective treatment options tailored to your specific needs and circumstances.
