Purpose: Keloids are noncontagious, pathologic, irregular deposits of collagen within an injured area and its boundaries. Only a few publications have described treatment of facial keloids, and there is obvious inconsistency regarding the treatment of facial keloids, specifically due to the high rate of recurrence and patient’s expectation of the results. Materials and Methods: We performed a literature review for more than 35 articles to draw attention to the management and treatment of facial keloids. Results: There are several surgical techniques for managing facial keloids. First involves simple surgical excision. Second strategy involves surgical excision of the keloid within the margin of the lesion, leaving keloid at the periphery to avoid violating the healthy tissue thus minimizing the recurrence. The third strategy involves simple surgical excision of the keloid followed by radiotherapy which appears to be the most effective treatment of the keloids. A fourth technique involves simple surgical excision of the keloid followed by steroid injection. A fifth technique involves excision of the keloid and using the keloid skin for resurfacing or as a skin flap to cover the surgical defect followed by HBO treatment. A sixth technique involves excision of the keloid followed by using Cryopreserved Placental Membrane. There are also non-surgical strategies to manage keloids. The first involves Intralesional injection with a mixture of 5-fluorouracil and Betamethasone and the second involves hydration and compression therapy. Conclusions: Facial keloids are very difficult to manage. In addition, they may develop complications including infections. It is imperative to make all attempts to prevent keloid formation, as the management regardless of modality, often leads to recurrence.
| Published in | International Journal of Clinical Oral and Maxillofacial Surgery (Volume 9, Issue 1) |
| DOI | 10.11648/j.ijcoms.20230901.12 |
| Page(s) | 4-8 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2023. Published by Science Publishing Group |
Keloids, Keloid Treatment, Keloid Radiotherapy, Facial Scars
| [1] | Abdus-salam, a. a., a. a. orekoya, m. a. jimoh and a. a. olabumuyi (2016). "radiotherapy treatment of keloids in ibadan." j west afr coll surg 6 (4): 104-116. |
| [2] | Aluko-olokun, b. and a. a. olaitan (2016). "strategy for successful management of facial keloid using triamcinolone injection as adjunct to surgery." j craniofac surg 27 (8): e775-e776. |
| [3] | Apikian, m. and g. goodman (2004). "intralesional 5-fluorouracil in the treatment of keloid scars." australas j dermatol 45 (2): 140-143. |
| [4] | Berman, b. and h. c. bieley (1996). "adjunct therapies to surgical management of keloids." dermatol surg 22 (2): 126-130. |
| [5] | Berman, b., a. maderal and b. raphael (2017). "keloids and hypertrophic scars: pathophysiology, classification, and treatment." dermatol surg 43 suppl 1: s3-s18. |
| [6] | Boahene, k., a. e. brissett and l. r. jones (2018). "facial plastic surgery controversies: keloids." facial plast surg clin north am 26 (2): 105-112. |
| [7] | Borok, t. l., m. bray, i. sinclair, j. plafker, l. labirth and c. rollins (1988). "role of ionizing irradiation for 393 keloids." int j radiat oncol biol phys 15 (4): 865-870. |
| [8] | Cheng, e. t., j. d. pollard and r. j. koch (2003). "effect of blended co2 and erbium: yag laser irradiation on normal and keloid fibroblasts: a serum-free study." j clin laser med surg 21 (6): 337-343. |
| [9] | Donkor, p. (2007). "head and neck keloid: treatment by core excision and delayed intralesional injection of steroid." j oral maxillofac surg 65 (7): 1292-1296. |
| [10] | Fikrle, t. and k. pizinger (2005). "cryosurgery in the treatment of earlobe keloids: report of seven cases." dermatol surg 31 (12): 1728-1731. |
| [11] | Goldan, o., o. weissman, e. regev, j. haik and e. winkler (2008). "treatment of postdermabrasion facial hypertrophic and keloid scars with intralesional 5-fluorouracil injections." aesthetic plast surg 32 (2): 389-392. |
| [12] | Granstein, r. d., a. rook, t. j. flotte, a. haas, r. l. gallo, h. s. jaffe and e. p. amento (1990). "a controlled trial of intralesional recombinant interferon-gamma in the treatment of keloidal scarring. clinical and histologic findings." arch dermatol 126 (10): 1295-1302. |
| [13] | Gupta, r. j., s. t. connelly, r. g. silva and n. r. gwilliam (2018). "use of viable cryopreserved placental membrane as an adjunct to facial keloid resection." plast reconstr surg glob open 6 (1): e1638. |
| [14] | Guy, w. m., p. pattisapu, j. ongkasuwan and a. e. brissett (2015). "creation of a head and neck keloid quality of life questionnaire." laryngoscope 125 (12): 2672-2676. |
| [15] | Hom, d. b. (2001). "treating the elusive keloid." arch otolaryngol head neck surg 127 (9): 1140-1143. |
| [16] | Juckett, g. and h. hartman-adams (2009). "management of keloids and hypertrophic scars." am fam physician 80 (3): 253-260. |
| [17] | Kiil, j. (1977). "keloids treated with topical injections of triamcinolone acetonide (kenalog). immediate and long-term results." scand j plast reconstr surg 11 (2): 169-172. |
| [18] | Klumpar, d. i., j. c. murray and m. anscher (1994). "keloids treated with excision followed by radiation therapy." j am acad dermatol 31 (2 pt 1): 225-231. |
| [19] | Koike, s., s. akaishi, y. nagashima, t. dohi, h. hyakusoku and r. ogawa (2014). "nd: yag laser treatment for keloids and hypertrophic scars: an analysis of 102 cases." plast reconstr surg glob open 2 (12): e272. |
| [20] | Kovalic, j. j. and c. a. perez (1989). "radiation therapy following keloidectomy: a 20-year experience." int j radiat oncol biol phys 17 (1): 77-80. |
| [21] | Lawrence, w. t. (1991). "in search of the optimal treatment of keloids: report of a series and a review of the literature." ann plast surg 27 (2): 164-178. |
| [22] | Liu, s., w. liang, k. song and y. wang (2018). "keloid skin flap retention and resurfacing in facial keloid treatment." aesthetic plast surg 42 (1): 304-309. |
| [23] | Mandrell, j., s. youker, e. j. allen, m. y. hurley and j. obadiah (2010). "keloid formation occurring in the distribution of a congenital vascular malformation." skinmed 8 (5): 298-300. |
| [24] | Morelli coppola, m., r. salzillo, f. segreto and p. persichetti (2018). "triamcinolone acetonide intralesional injection for the treatment of keloid scars: patient selection and perspectives." clin cosmet investig dermatol 11: 387-396. |
| [25] | Muti, e. and e. ponzio (1983). "cryotherapy in the treatment of keloids." ann plast surg 11 (3): 227-232. |
| [26] | Nair, s. p., g. n. kumar and r. mathew (2016). "histoid leprosy presenting with keloid like lesions." indian j lepr 88 (2): 117-121. |
| [27] | Rasheed, i. a. and a. e. malachy (2014). "the management of helical rim keloids with excision, split thickness skin graft and intralesional triamcinolone acetonide." j cutan aesthet surg 7 (1): 51-53. |
| [28] | Sallstrom, k. o., o. larson, p. heden, g. eriksson, j. e. glas and u. ringborg (1989). "treatment of keloids with surgical excision and postoperative x-ray radiation." scand j plast reconstr surg hand surg 23 (3): 211-215. |
| [29] | Sawada, y. and k. sone (1992). "hydration and occlusion treatment for hypertrophic scars and keloids." br j plast surg 45 (8): 599-603. |
| [30] | Sclafani, a. p., l. gordon, m. chadha and t. romo, 3rd (1996). "prevention of earlobe keloid recurrence with postoperative corticosteroid injections versus radiation therapy: a randomized, prospective study and review of the literature." dermatol surg 22 (6): 569-574. |
| [31] | Seegenschmiedt, m. h., o. micke and r. muecke (2015). "radiotherapy for non-malignant disorders: state of the art and update of the evidence-based practice guidelines." br j radiol 88 (1051): 20150080. |
| [32] | Shen, j., x. lian, y. sun, x. wang, k. hu, x. hou, s. sun, j. yan, l. yu, x. sun, w. li, x. wang, q. guan, t. pang and f. zhang (2015). "hypofractionated electron-beam radiation therapy for keloids: retrospective study of 568 cases with 834 lesions." j radiat res 56 (5): 811-817. |
| [33] | Sherman, r. and h. rosenfeld (1988). "experience with the nd: yag laser in the treatment of keloid scars." ann plast surg 21 (3): 231-235. |
| [34] | Tahim, a., s. ali and l. cheng (2018). "an intra-oral approach to facial skin lumps-a move towards scarless surgery." oral maxillofac surg 22 (3): 285-288. |
| [35] | Tan, k. t., n. shah, s. a. pritchard, d. a. mcgrouther and a. bayat (2010). "the influence of surgical excision margins on keloid prognosis." ann plast surg 64 (1): 55-58. |
| [36] | Van leeuwen, m. c., s. c. stokmans, a. e. bulstra, o. w. meijer, m. w. heymans, j. c. ket, m. j. ritt, p. a. van leeuwen and f. b. niessen (2015). "surgical excision with adjuvant irradiation for treatment of keloid scars: a systematic review." plast reconstr surg glob open 3 (7): e440. |
| [37] | Wang, q. g., x. m. li, m. zhang, h. li, b. wen, h. z. li and x. s. gao (2014). "[effect of two dose fractionations on postoperative radiotherapy of keloid: an analysis of 107 patients]." beijing da xue xue bao yi xue ban 46 (1): 169-172. |
| [38] | Zouboulis, c. c., e. zouridaki, a. rosenberger and a. dalkowski (2002). "current developments and uses of cryosurgery in the treatment of keloids and hypertrophic scars." wound repair regen 10 (2): 98-102. |
APA Style
Yousef Alshamrani, Fawaz Alotaibi, Yoh Sawatari, Abdulrahman Hesham. (2023). Management of Complex Facial Keloid -- A Review of the Literature. International Journal of Clinical Oral and Maxillofacial Surgery, 9(1), 4-8. https://doi.org/10.11648/j.ijcoms.20230901.12
ACS Style
Yousef Alshamrani; Fawaz Alotaibi; Yoh Sawatari; Abdulrahman Hesham. Management of Complex Facial Keloid -- A Review of the Literature. Int. J. Clin. Oral Maxillofac. Surg. 2023, 9(1), 4-8. doi: 10.11648/j.ijcoms.20230901.12
AMA Style
Yousef Alshamrani, Fawaz Alotaibi, Yoh Sawatari, Abdulrahman Hesham. Management of Complex Facial Keloid -- A Review of the Literature. Int J Clin Oral Maxillofac Surg. 2023;9(1):4-8. doi: 10.11648/j.ijcoms.20230901.12
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Download@article{10.11648/j.ijcoms.20230901.12,
author = {Yousef Alshamrani and Fawaz Alotaibi and Yoh Sawatari and Abdulrahman Hesham},
title = {Management of Complex Facial Keloid -- A Review of the Literature},
journal = {International Journal of Clinical Oral and Maxillofacial Surgery},
volume = {9},
number = {1},
pages = {4-8},
doi = {10.11648/j.ijcoms.20230901.12},
url = {https://doi.org/10.11648/j.ijcoms.20230901.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcoms.20230901.12},
abstract = {Purpose: Keloids are noncontagious, pathologic, irregular deposits of collagen within an injured area and its boundaries. Only a few publications have described treatment of facial keloids, and there is obvious inconsistency regarding the treatment of facial keloids, specifically due to the high rate of recurrence and patient’s expectation of the results. Materials and Methods: We performed a literature review for more than 35 articles to draw attention to the management and treatment of facial keloids. Results: There are several surgical techniques for managing facial keloids. First involves simple surgical excision. Second strategy involves surgical excision of the keloid within the margin of the lesion, leaving keloid at the periphery to avoid violating the healthy tissue thus minimizing the recurrence. The third strategy involves simple surgical excision of the keloid followed by radiotherapy which appears to be the most effective treatment of the keloids. A fourth technique involves simple surgical excision of the keloid followed by steroid injection. A fifth technique involves excision of the keloid and using the keloid skin for resurfacing or as a skin flap to cover the surgical defect followed by HBO treatment. A sixth technique involves excision of the keloid followed by using Cryopreserved Placental Membrane. There are also non-surgical strategies to manage keloids. The first involves Intralesional injection with a mixture of 5-fluorouracil and Betamethasone and the second involves hydration and compression therapy. Conclusions: Facial keloids are very difficult to manage. In addition, they may develop complications including infections. It is imperative to make all attempts to prevent keloid formation, as the management regardless of modality, often leads to recurrence.},
year = {2023}
}
TY - JOUR T1 - Management of Complex Facial Keloid -- A Review of the Literature AU - Yousef Alshamrani AU - Fawaz Alotaibi AU - Yoh Sawatari AU - Abdulrahman Hesham Y1 - 2023/06/06 PY - 2023 N1 - https://doi.org/10.11648/j.ijcoms.20230901.12 DO - 10.11648/j.ijcoms.20230901.12 T2 - International Journal of Clinical Oral and Maxillofacial Surgery JF - International Journal of Clinical Oral and Maxillofacial Surgery JO - International Journal of Clinical Oral and Maxillofacial Surgery SP - 4 EP - 8 PB - Science Publishing Group SN - 2472-1344 UR - https://doi.org/10.11648/j.ijcoms.20230901.12 AB - Purpose: Keloids are noncontagious, pathologic, irregular deposits of collagen within an injured area and its boundaries. Only a few publications have described treatment of facial keloids, and there is obvious inconsistency regarding the treatment of facial keloids, specifically due to the high rate of recurrence and patient’s expectation of the results. Materials and Methods: We performed a literature review for more than 35 articles to draw attention to the management and treatment of facial keloids. Results: There are several surgical techniques for managing facial keloids. First involves simple surgical excision. Second strategy involves surgical excision of the keloid within the margin of the lesion, leaving keloid at the periphery to avoid violating the healthy tissue thus minimizing the recurrence. The third strategy involves simple surgical excision of the keloid followed by radiotherapy which appears to be the most effective treatment of the keloids. A fourth technique involves simple surgical excision of the keloid followed by steroid injection. A fifth technique involves excision of the keloid and using the keloid skin for resurfacing or as a skin flap to cover the surgical defect followed by HBO treatment. A sixth technique involves excision of the keloid followed by using Cryopreserved Placental Membrane. There are also non-surgical strategies to manage keloids. The first involves Intralesional injection with a mixture of 5-fluorouracil and Betamethasone and the second involves hydration and compression therapy. Conclusions: Facial keloids are very difficult to manage. In addition, they may develop complications including infections. It is imperative to make all attempts to prevent keloid formation, as the management regardless of modality, often leads to recurrence. VL - 9 IS - 1 ER -
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