Cryotherapy and Keloid Treatment

About Dr. Jason Hamilton

Jason S. Hamilton, M.D. is the Director of Plastic and Reconstructive Surgery for the Osborne Head and Neck Institute based at Cedar-Sinai Medical Towers. Dr. Hamilton has advanced training in plastic and reconstructive surgical techniques involving the face, head, and neck, and limits his practice to the treatment of these areas exclusively.

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About Dr. Hootan Zandifar

Dr. Hootan Zandifar is board-certified in Otolaryngology and fellowship-trained in Facial Plastics and Reconstructive Surgery. Dr. Zandifar is the director of the Skin Center at the Osborne Head and Neck Institute based at Cedars-Sinai Medical Towers.

Is cryotherapy an effective treatment for keloids?

Question: A few years ago I had surgery to remove a small growth from my ear. A few months after the procedure I noticed that I was left with a scar that continued to grow. My doctor diagnosed me with a keloid and said that I could have it removed but the likelihood of recurrence would be high. A friend of mine suggested cryotherapy. Will cryotherapy permanently remove my keloid?

Figure 1. Keloid lesion behind the right ear before and after cryotherapy treatment. Notice regression of the keloid after one treatment. (Courtesy of Drs. Yaron Har-Shai, Z.Paul Lorenc, cyroshape.com)
Figure 1. Keloid lesion behind the right ear before and after cryotherapy treatment. Notice regression of the keloid after one treatment. (Courtesy of Drs. Yaron Har-Shai, Z.Paul Lorenc, cyroshape.com)

Discussion:

Cryotherapy is a safe and effective treatment for keloids with a success rate greater than 97%. Unlike other treatments, the goal of cryotherapy is to treat the keloid from the inside out, thereby eradicating the tissue in its entirety and greatly reducing the likelihood of recurrence. Other treatments attempt to treat the surface of the lesion with little to no success. Steroid injections attempt to reduce the size of the scar but can often lead to undesirable pigment changes or even skin atrophy. Surgical excision attempts to remove the lesion but carries a large risk of recurrence and larger scar formation. Cryotherapy is a superior choice to conventional keloid treatments because of its high efficacy, minimal discomfort, and remote risk of complication.

Cryotherapy is a relatively painless and fast procedure. After a local anesthetic has been applied to numb the area, a special needle is passed through the middle of the scar. Liquid nitrogen is passed through the needle, never coming in contact with the skin or the scar. The deep tissues of the keloid freeze, disrupting the blood supply of the lesion. Throughout this process, the underlying skin and vasculature is protected and unharmed, causing minimal if any change in skin pigment. The patient recovers from the procedure almost immediately noting resolution of typical keloid symptoms such as itching, burning, and pain. Since sutures are not necessary after treatment, patients can return to their regular activities the same day with minimal, if any, impact to their lifestyle. Additionally, most patients require only a single treatment for effective removal of a keloid.

Figure 2: A keloid located on the ear lobe that resulted from a routine ear piercing.
Figure 2: A keloid located on the ear lobe that resulted from a routine ear piercing.

Keloids are large scars that have resulted from the overproduction of collagen. The cellular machinery that is responsible for normal scar production is thought to be oversensitive or deregulated in some people. Individuals with darker skin tones, certain races, and age groups 10-30 are most susceptible to the formation of keloids.

In all cases of keloids or hypertrophic scars, appropriate evaluation by a qualified physician is recommended in deciding which treatment plan is best for your individual situation. The physicians of the Osborne Head and Neck Institute have performed numerous keloid and scar revision procedures, including cryotherapy. Dr. Jason Hamilton and Dr. Hootan Zandifar have established in their practice the use of cryotherapy in treating keloids with great success.

Key Points:

  • Cryotherapy has a 97% success rate in non-recurrence of keloid scars.
  • Topical keloid treatments are usually ineffective because they only treat the surface of the lesion, allowing an opportunity for recurrence.
  • Steroid treatments can carry complications such as skin atrophy and pigment changes.
  • Surgical excision carries a very high rate of recurrence and keloid enlargement.
  • Cryotherapy is a brief and relatively painless procedure usually requiring only one procedure and minimal recuperation time.

To learn more about cryotherapy treatment for Keloids, please contact the Osborne Head and Neck Institute.