Keloids: Current therapies in Barbados

Abstract

Keloids are characterised by scar tissue overgrowth on the skin beyond the borders of the original wound following an abnormal wound healing process and tend not to regress. These disfiguring scars can cause pain, itching and inflammation in the patient leading to an emotional and psychological impact and a sub-standard quality of life. A variety of treatments, using surgical and non-surgical approaches, exists that have been reported to be beneficial. However, no one treatment currently stands out as the most optimal due to a number of factors including different keloid subtypes. Often, a combinational approach to its treatment generates the best results. The incidence of keloid and hypertrophic scarring is very high in African, Hispanic and Asian populations and as yet, the multifactorial aetiology of this disorder is still not clear. Very few published studies on keloid scarring among the Caribbean population and, in particular, the Barbadian population has been reported to-date. The aim of this review is to explore and discuss the current literature of the various keloid treatment modalities typically used in Barbados along with keloid management. These treatments include: the intralesional corticosteroid injection triamcinolone acetonide, imiquimod, excision, pressure dressing, cryotherapy, silicone gel sheeting and radiation. Regarding keloid management, a well-planned treatment strategy tailored to suit the individual patient's needs by an experienced healthcare physician is key in achieving the best outcome with improved cosmesis. The management of the patients' symptoms as well as patients' compliance with post-treatment care, is also an important factor to consider.