Adult stem cells have been gaining traction over the years as potential candidates for cell-based wound repair and scar therapy. Mesenchymal stem cells (MSCs) have been well described with numerous studies having demonstrated their potential to accelerate wound repair by increasing migration, angiogenesis and re-epithelialisation via paracrine signalling. 137, 138 MSCs secrete growth and differentiation factors that regulate inflammatory and immune responses during wound healing. 139, 140 The cells can be delivered to the wound either directly (e.g. through injecting, spraying or systemic administration) or via skin scaffolds. 138 Recently, the antifibrotic properties of MSCs, though paracrine signalling, have been demonstrated in vitro in keloid fibroblasts and in a dermal fibrosis murine model. 141, 142 These findings have provided new understanding and MSC-based therapeutic application for scar treatment. Some studies, however, have reported possible pro-inflammatory effects of MSCs, which promote formation of keloids. 143 Hence, more studies are needed to elucidate their efficacy in keloid treatment. Another stent-type of pressure device custom-molded from methyl methacrylate demonstrated an 83% success rate in a small study involving 23 patients who used them following surgical removal of the ear keloids. 23 Custom-made silicon molds can be used as a more effective compression therapy option for ear keloids that extend beyond the ear lobe. 24 Laser therapy for keloid treatment was introduced in the 1980s. 97 Since then, different systems have been used for the treatment of keloid and hypertrophic scars. 48, 98 These lasers target skin chromophores like haemoglobin and melanin, based on the principle of selective photothermolysis. 99 Lasers can be classified as ablative and non-ablative. The most common ablative lasers include the 2940-nm erbium-doped yttrium aluminium garnet (Er:YAG) laser and the 10,600-nm carbon dioxide (CO 2) laser. These emit a laser beam that is absorbed by water in the skin leading to local tissue destruction and reduction of lesion volume. 3 Common examples of non-ablative lasers include 585-nm or 595-nm PDLs, 1064-nm neodymium-doped:yttrium-aluminium-garnet (Nd:YAG) laser, 532-nm neodymium-doped:vanadate (Nd:Van) laser and 1064 nm Q-switched Nd:YAG laser with low fluence. 100 These lasers induce thermal injury to the scar’s microvasculature leading to thrombosis and ischaemia which result in collagen denaturation and collagen fibre realignment. 101 – 103 Several clinical studies show that silicone gels can improve the texture and fade the color of keloids. One study found that 34 percent of raised scars became significantly flatter after daily application of a silicone gel. Jenwitheesuk K, et al. (2012). Role of siliconederivative plus onion extract gel in presternal hypertrophic scar protection: Aprospective randomized, double blinded, controlled trial [Abstract]. DOI:

Monstrey S, Middelkoop E, et al. “Updated scar management practical guidelines: Non-invasive and invasive measures.” J Plast Reconstr Aesthet Surg. 2014;67(8):1017-25. There are also several nonsurgical treatment options you can try. While you might not be able to completely get rid of a keloid, many of these options can help to significantly shrink it. Corticosteroids and other injections Tattoo, body piercing, or cosmetic procedure: These all injure the skin, which means you could develop a keloid afterward if you’re prone to getting keloids. The best way to prevent a keloid is to skip the body art and cosmetic procedures. Doctors can inject medications directly into your keloid to help shrink it, relieve symptoms, and make it softer. You’ll receive injections every three to four weeks until the keloid improves. This usually takes about four office visits. If you’re concerned that a cosmetic procedure may cause a keloid, tell your dermatologist or other doctor who will perform the procedure. Your dermatologist may recommend another treatment option or try a test spot.Meaume S, Le Pillouer-Prost A, et al. “Management of scars: Updated practical guidelines and use of silicones.” Eur J Dermatol. 2014;24(4):435-43.

However, pressure earrings are also very uncomfortable for most people, and they need to be worn for 16 hours a day for 6 to 12 months. Radiation Free to everyone, these materials teach young people about common skin conditions, which can prevent misunderstanding and bullying. Find a dermatologist Surgery, including dental surgery: A keloid can develop on your skin or inside your mouth. When you need surgery, here’s what can reduce your risk of developing a keloid:According to research, compression may work by decreasing oxygen and blood flow to the wound, creating conditions that help get rid of the cells that produce collagen and also shrink keloid scar tissue. Examination of pressure-treated keloids by an electron microscope confirmed that there was less cohesiveness between collagen fibers, indicating the breakdown of collagen nodules in keloid tissue. 3, 8