- Steroid injections - Steroid injections are best used as the scar begins to thicken or if the person is a known keloid former. A series of 3-4 injections with triamcinolone acetonide (10mg or 40mg/ml) are given every 3-4 weeks. The fibrosis reduces which is evident in the form of softness of the lesion ,reduction of size and flattening .
- Botulinum toxin - Recent International studies have documented use of Botulinum toxin in Keloids and Scars. It can be used alone or with steroid injections.It has been found that , if perilesional botulinum toxin is injected at the time of injecting steroid there is faster improvement and sustained result in case of keloids.
- Cryosurgery - Cryosurgery is an excellent treatment for keloids which are small and occur on lightly pigmented skin. It is often combined with monthly cortisone injections. It freezes the skin and causes sludging of the circulation beneath, effectively creating an area of localized frostbite. There is a slough of skin and keloid with renewed skin surface.
- Surgery - Surgery requires great care during and after the operation. Keloids that return after being excised may be larger than the original. There is a 50% chance of recurrence after surgical removal. However, keloids are less likely to return if surgical removal is combined with other treatments such as intralesional steoids.
- Laser therapy — This is an alternative to conventional surgery for keloid removal. Lasers produce a superficial peel but often do not reduce the bulk of the keloid. Pulsed dye laser and IPL work well for keloids. A relatively new approach is to combine laser therapy with steroid injections and the use of Silicone Sheeting.
- MNRF: It is a great option for keloids,especially in combination wit ILS/Botox.