Tips from Dermatologists Dr. Joshua Fox and Dr. Lance Barazani on Removing Painful Keloid Scars For Good with New Radiotherapy Treatment

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Queens, NY Man Finds Relief from Keloid Pain

Dr. Joshua Fox

In most cases, keloids are only unsightly. But some keloids are uncomfortable (itchy and sometimes painful), and a few are truly troublesome, causing contractures (a narrowing or shortening of muscle) that inhibit movement.

Earlier this year, Michael (name has been changed to protect the patient’s privacy), a 27 year old from Queens, had had enough. He’d had a keloid scar—a type of tissue overgrowth that plagues roughly 10 percent of the population, most often people with dark skin—for several years. Michael had been getting the standard course of treatment for it—several rounds of corticosteroid injections and three surgeries—which had temporarily suppressed the keloid but never resolved it. In fact the keloid came back worse over time. Now, in increasing discomfort, he was ready to try something else. Michael met with Dr. Joshua Fox, founder and director of Advanced Dermatology PC, who told him about a new treatment that could get rid of the scar—with minimal chance of recurrence. Dr. Fox coordinated the care with Dr. Lance Barazani, director of the radiotherapy unit at the practice.

Understanding Keloids
“A keloid is an overgrowth of scar tissue that typically develops at the site of an old injury,” Dr. Fox says. They most often affect blacks and people of Latin or Asian descent, whose darkly pigmented skin seems to make them more susceptible than whites (experts also have identified a genetic component to keloids). Research shows that dark-skinned people are 15 to 20 times more likely to develop keloid scars than their lighter-skinned counterparts. Athletes and pregnant women are also more susceptible to keloids.

Unfortunately, keloid scars are often a thorny issue, for both the patient and the doctor, Dr. Fox explains. “Scarring is part of the natural healing response—the body’s way to repair damage and fortify the area against further injury.” But in some people, the scarring goes too far, and the body lays down excessive fibrous tissue.

“In most cases, keloids are only unsightly,” Dr. Fox continues. But some keloids are uncomfortable (itchy and sometimes painful), and a few are truly troublesome, causing contractures (a narrowing or shortening of muscle) that inhibit movement or create serious disfigurement. (Michael’s keloid scar was making it difficult and painful for him to move his neck.)

Tips on new New Radiotherapy Treatment Keloids
Until now, Dr. Barazani says, the best course of treatment for keloids like Michael’s was steroid injections and possibly surgery, both of which carry a significant risk of recurrence (in many cases, more than 50 percent). Surgical removal can often make the problem worse, as the scar may grow back even bigger than it was before the operation. But today, keloids can be eradicated—in most cases, for good—with a new treatment that uses superficial radiotherapy, SRT for short, to prevent the surrounding skin from becoming reactive and reforming a painful keloid after surgical removal. SRT is painless and usually takes one or two treatments. Recurrence rates are typically reduced to less than 5 percent. In Michael's case, SRT has resolved both his keloid scar and his intense pain, with a greatly diminished chance of recurrence.

SRT is FDA-approved to treat certain types of non-melanoma skin cancer as well as keloid scars, Dr. Barazani explains. It works a little bit like the radiation treatments that are used to treat other forms of cancer, with one significant difference: SRT targets skin cells close to the surface—less than 5mm deep—to effectively eradicate the cancerous cells (or, in the case of keloids, stop the overgrowth of scar tissue) without damaging the healthy cells beneath. The procedure is painless, and in cases where it’s used to treat painful or otherwise problematic keloids, is eligible for insurance coverage.

Joshua L. Fox, M.D., F.A.A.D., Medical Director at Advanced Dermatology PC.

Lance Barazani, M.D., F.A.A.D., Director of Radiotherapy at Advanced Dermatology PC

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies.

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