Keloid scars can be one of the most devastating aesthetic issues a person can face. The good news is that there are treatment options, including one that has, until now, been only focused on skin cancers: SRT. Much more information on this will be covered at the TSLMS annual meeting and conference in May, Scale 2019 Music City.
As noted in our prior blog:
Keloids are visually very distinct scars. They are red to purple, raised, and large relative to the surrounding skin. They can be incredibly uncomfortable (itchy or outright painful) and make the surrounding area feel tight. Frequently the scars grow bigger than the original wound ever was and, when big enough, can end up restricting movement and interfering with normal life. This does not necessarily cause any type of serious medical issues, as much as it is an inconvenience and annoyance, but that all depends on the severity of the discomfort. However, keloids frequently have serious cosmetic implications…
When the dermis layer of the skin is wounded, the body responds by producing new collagen, which acts to bind and mend the skin. This granulation of new tissue is what causes the scar and, in many cases, the scar will simply fade away over time. In the case of keloids, though, they grow instead.
As noted above, keloids can be triggered by any type of injury to the skin, including those that seem relatively insignificant. This includes such things as acne scars, ear piercings, scratches, vaccination sites and chickenpox. They can also appear at the sites of more significant trauma areas like surgical incisions, cuts and burns. In fact, “According to the American Osteopathic College of Dermatology, an estimated 10 percent of people experience keloid scarring. Men and women are equally likely to have keloid scars. Other risk factors include being pregnant and being younger than 30. Keloids tend to have a genetic component, which means you’re more likely to have keloids if one or both of your parents has them. According to one study, a gene known as the AHNAK gene may play a role in determining who develops keloids and who doesn’t. The researchers found that people who have the AHNAK gene may be more likely to develop keloid scars than those who don’t.” (Source).
Keloid Scar Treatment
“Keloids are hard to treat, largely because of their unpredictable nature, high recurrence rate, and the dearth of consistently effective treatments. The pathogenesis of keloids is poorly understood, and we don’t understand why certain patients are more susceptible than others. We also do not know why keloids are more common on certain skin sites, such as the ears, chest, and back… There are no FDA-approved drug treatments for keloid scars. A device that delivers superficial radiation, the Sensus SRT-100, is FDA approved for keloid removal. Other available options include excision (with or without repair), steroid injections, intralesional 5-Fluorouracil (5-FU), radiation therapy, imiquimod, silicone gel or silicone sheeting, pressure devices, botulinum toxin injections, cryotherapy, and lasers.” (Source).
Most of these treatment options are non-invasive. The simple elegance of laser treatment and cryotherapy, and the surprising efficacy of botulinum toxin, make keloids a problem that can be addressed in most professional settings by educated providers.
SRT for Keloid Treatment
Superficial Radiation Therapy (SRT) has historically been used to treat cancer. However, research scientists and doctors have lately figured out that SRT can also be enormously effective in treating keloids.
Treatment of keloids presents a unique clinical challenge: clearing them the first time is not overly difficult, but preventing them from returning can be challenging. A number of modalities have been suggested to reduce recurrence; most strategies are pharmacologic in nature, including injected triamcinolone or fluorouracil (5FU).
Newer superficial radiation therapy (SRT) platforms, however, offer the potential to significantly change this paradigm. The Sensus SRT-100 platform utilizes a short wavelength/ tight penumbra beam to deliver specific and targeted energy only to tissue of interest, with no effect to adjacent tissue. Most importantly, it has been shown to be more than 90 percent effective in reducing recurrence of keloids in various clinical studies. (Source).
Note that this is primarily useful in preventing the recurrence of these scars. The leading manufacturer of this treatment is Sensus Health Care. They describe the technology as follows:
Keloid scars continue to grow, it is important to offer the best keloid treatment available to patients around the United States and the rest of the world. While keloid removal normally involves several surgeries due to the keloids growing back at the new incision sites in up to 90 percent plus of cases, when surgical removal is followed by SRT, recurrence rates drop to as low as 10 percent. The SRT-100™ delivers a precise, calibrated dose of SRT Therapy that only goes skin deep, safely destroying the cells that form keloids and keeping the skin smooth while the incision heals.
This procedure can be performed right in your office, and each treatment session is painless for the patient. There is no need for anesthesia, cutting, or stitching, and no risk of infection, continued scarring, or bleeding. Patients will usually undergo a series of treatments depending on the condition of the incision site.
The SRT-100™ is FDA approved and is perfect for private practices, hospitals, and multi-locale healthcare providers.
If you work in our field this is an important topic to follow – and we hope you do.