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Treatment of keloid scars of earlobes
Last reviewed: 19.10.2021
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The variety of clinical variants of keloid scars leads to the need to develop various ways of approaching the problem and creating various treatment regimens. So treatment of keloid scars of earlobes has its own peculiarities. Most often they are small in size, but despite this, this pathology delivers to its owners many problems due to localization in prominent places. Patients can not open their ears, put on earrings and clips! Unfortunately, because of the low professionalism of workers in the service sector of beauty salons, non-observance of the elementary rules of asepsis and antiseptics, failure to inform clients about the rules of care for puncture sites, this pathology is often encountered. This is partly due to the use for the puncture of special "pistols" with small earrings on screws and with the disappearance from the sale of "hygienic" silver light earrings on a thin arch in pharmacies that made it easy to care for the puncture site. Many patients do not even realize that the globular formation that appears on the puncture site is a keloid scar that needs to be treated and when they turn to the doctor, the scar becomes bigger and harder to treat.
In the literature there are single publications on the treatment of keloid scars of the auricles. Most authors suggest surgical removal followed by the use of pressing clips or radiotherapy, or injections of corticosteroids. If the earlier publications sounded just surgical removal (cutting), then the latest publications talk about the deep removal of scar tissue with skin separation, 1-2 mm thick. And the attachment of this flap to the site of the remote scar.
Optimum treatment of keloid scars of earlobes is preferably done as follows.
In case the scar is growing.
Stage 1. Corking with the Kenog-40 or diprospan in the keloid base.
2 stage. Not earlier than one month after splitting, perform electro- or laser excision to the base of the keloid. Often this is accompanied by the removal of scar tissue almost to the epidermis of the opposite surface of the earlobe.
Stage 3. After healing of the wound surface, irradiation with Bucca rays or conducting a session of close-focus X-ray therapy. In this case, the patient should wear a pressing clip for at least 6 months and at least 12 hours a day.
Note! With the rapid removal of a large keloid, there may be a decrease in the area of the lobe, which should be warned by the patient.
4 th stage. Electrophoresis with Lidase No. 10 is performed, and after 2 weeks electrophoresis with collagenase No. 10 every other day.
5 stage. Phonophoresis with contractubex 15 procedures daily or every other day.
Stage 6. In case of appearance of rumen growth, despite the treatment, there is a need for microinjection of diprospan in combination with Bucca-irradiation or close-focus X-ray therapy. With continued growth of the rumen, methotrexate may be used.
In case the scar is stabilized (no signs of growth).
Necessity in the scarring before the operation of prolonged corticosteroids is not present and the treatment begins with an operational removal.
The last stage may not be with a favorable course of treatment.
The optimal methods and means for treating keloid scars are all available and listed methods and means. However, among them one can emphasize:
- hormonal therapy;
- pyrotherapy;
- Bucca-irradiation;
- squeezing means;
- reduction from the inside by surgical methods;
- laser and electric excisions.