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Dr. Rick, MD
Dr. Rick, MD, Board Certified MD
Category: Dermatology
Satisfied Customers: 11160
Experience:  20+ years as a doctor. Internal Medicine Internship in NYC
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I have a keloid above my chest. I have been trying to get

Customer Question

I have a keloid above my chest. I have been trying to get rid of it. I went to a dermatologist who injected steroid about 4 different times. It does not seem to be working. I wonder what I can do to get rid of it for once
Submitted: 1 year ago.
Category: Dermatology
Expert:  Dr. Nair replied 1 year ago.

Hello,

Thank you for your question. My name is***** and I will do my best to provide a useful input.

Would a photograph of the affected area be possible at your convenience?

Customer: replied 1 year ago.
Here you go!
Expert:  Dr. Nair replied 1 year ago.

Good Morning,

Thank you for the photograph. Okay so my first choice for a small keloid like this would still be Intralesional Steroid in the form of Triamcinolone. The key to success with this is to inject the full strength of 40 mg/ml once every 3 weeks - usually flattens out the keloid in 3-4 injections. If your doctor has used this strength without success then other modalities can be looked at.

These would include 5-FU injections in the keloid, mixing Hyaluronidase with the steroid and injecting, or Silicone gel sheath. The gel sheath is non-invasive and can work quite well. It needs to be stuck on the keloid area for at least 8-12 hours a day to begin with. Takes 2-3 months to flatten out a keloid. You can even buy it without a prescription.

Other more invasive options are cryotherapy and Fractional Co2 Laser. The former can cause permanent whitening of the skin while the latter needs to be combined with either steroid injections/layering or silicone sheaths for success.

Please feel free to ask if you have any queries. I will be happy to continue further and do everything I can to provide you with the service you seek.

Customer: replied 1 year ago.
Thanks for the answer.
-If I take more than 3 weeks in between steroid sessions is it okay? Like 4 or 4 weeks.
-Since I am not an expert I am a little confused as far as what to do. I live both in NY and LA. do you suggest I go to some specific doctor? What would youy recommend me at this point? I have not been seeing significant results
Expert:  Dr. Nair replied 1 year ago.

Good Morning,

Yes 4 weeks is not a problem. Up to 6 weeks gap is normally okay.

I would suggest the full strength steroid injections as the first option. This can be done by any dermatologist. To make the injections more effective you can also start using the silicone gel sheath as advised.

Kindly consider rating our interaction to enable me to get credit for my work with you. You can continue to follow up even after if required. Thank you.

Customer: replied 1 year ago.
Sir, but as I mention first in my question I have been going to a dermatologist who has been doing this for 4 or 5 times. I did not see a lot of improvement on it.Also is that gel over the counter?
Expert:  Dr. Nair replied 1 year ago.

That's what I was clarifying - if he has used the dose of steroid I mentioned then one of the other treatment modalities I mentioned must be tried. If he has used a weaker strength of steroid then the full dose must be tried first. Sorry if this is confusing.

The Silicone gel must be used in the form of a sheath, not gel. Yes it is available over the counter. This is an example:

http://www.smith-nephew.com/key-products/advanced-wound-management/cicacare/

Customer: replied 1 year ago.
Doctor, Very last thing: Is the silicone gel the same as a silicone patch?
I should use it when sleeping?
Expert:  Dr. Nair replied 1 year ago.

No its not - you need the silicone patch, also called a silicone gel sheath. Silicone gel is different and not very effective for keloids.

Kindly rate our interaction to enable me to get credit for my work with you. Regards.

Customer: replied 1 year ago.
Sir, I will definitely give you 5 stars. But let me clarify something. You mentioned first I needed a silicone gel. Then you said silicone gel is not very effective for keloids. But you also said they are the same thing.
Could you please clarify all that? hehe
Expert:  Dr. Nair replied 1 year ago.

'Silicone gel' and 'Silicone gel sheath' are two different things - I never mentioned 'Silicone gel' as being effective for keloids - please read the first answer again. 'Silicone Gel Sheath' is also called a 'Silicone patch' - This is what you need to get. I sent you a link of the kind of product I am talking about.

Hope that clarifies your doubt. Regards.

Customer: replied 1 year ago.
Last piece : IS this it? http://www.amazon.com/gp/product/B001AJ4L1E?keywords=silicone%20patch&qid=1455188770&ref_=sr_1_1&sr=8-1
Expert:  Dr. Nair replied 1 year ago.

Yes

Expert:  Dr. Rick, MD replied 1 year ago.

Hi. My name is***** and I am online and available to help you today. Thank you for your patience.

Question and answer is just one of the services I offer. I can also provide you with additional services, such as live telephone or skype consultation, at a small additional cost. Let me know if you are interested.

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This is not an answer, but an Information Request. I need this information to answer your question. Please reply, so I can answer your question. I look forward to helping you.