Improved Outcomes Managing Keloid Scars with Use of Polymeric Membrane Dressings

Purpose: Keloid scars are often difficult to manage. They can be very painful and/or very itchy as they grow over normal skin. No treatments for keloids are considered to be 100% effective. Infected keloids often ulcerate. If the keloid is surgically removed there is a greater than 50% probability that it will return. This dermatology office was looking for improved methods for resolving keloids because they are common in this practice’s patient population.

Methodology: Four patients with keloids were managed with new approaches. Two patient’s keloids were managed with Triamcinolone Acetonide intralesional injections and then covered with polymeric membrane dressings.  Two patient’s keloids were only covered with polymeric membrane dressings and did not receive Triamcinolone Acetonide intralesional injections. One of these patient’s keloid had been present for 8 years and had been treated  with Triamcinolone Acetonide injections in the past without improvement.

The polymeric membrane dressings were evaluated in these cases because of their previously observed anti-inflammatory actions when applied to wounds. One hypothesis of keloid and hypertrhophic scar formation is related to overexpression of neuropeptide release as a result of excessive nociceptor activity at the site of injury. Polymeric membrane dressings have been shown to reduce nocicpeptor activity while concentrating the inflammatory response required for healing into the actual site of injury.

Outcomes: All four patients experienced improvements in their keloid scars. The improvements included elimination of both pain and itching, reduced pigmenation, flattening of the scars and improved suppleness of the scars. The two patients who did not have intralesional injections progressed as well as those that had the intralesional injections.

Conclusion: Polymeric membrane dressing should be considered for the purpose of improving the management of keloid scars.