The healing of keloid scars is particularly difficult. A number of scar services offer partial (intralesional) removal of keloid scars, which is often combined with steroid medication, although complete (intralesional) removal and radiotherapy are the most effective treatment modalities.
The goal of this study was to see how efficient partial keloid removal is in clinical practice. There is limited evidence that this technique can produce reliable results over the long term; emerging data on the scar-forming properties of different parts of keloids, as well as the mechanical factors contributing to keloid formation, do not support partial scar removal for this subset of scars.
There is a complex pathogenesis underlying keloid scarring, including fibroblast proliferation, apoptosis, and endothelial dysfunction. Research suggests that hypertrophic and keloid scars are contiguous scar types, with keloids representing the severe end of hypertrophy due to prolonged and intense inflammatory activity within the dermis.
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