Excision and Radiotherapy

Immediately after treatment:

  • Immediately after excision, you will have stitches at the site where the keloid was removed.

Days and weeks after treatment:

  • You will likely receive the first dose of radiotherapy within the first 3 days after excision.
  • The stitches will be removed 7-10 days after excision. Your doctor may recommend taping the wound with medical tape or Steri-strips® at night for up to 6 months in order to avoid friction on the wound, which could delay the healing process.
  • Almost all patients experience temporary skin redness at the treatment site, which appears between 10 days and 3 weeks after radiotherapy.

Longer term:

  • Many patients experience skin darkening (hyperpigmentation) at the treatment site, which may take months to disappear. A small number of patients experience skin lightening (hypopigmentation) or loss of normal skin markings (skin atrophy), but these side effects also eventually disappear.
  • Another rare side effect is the appearance of small dilated blood vessels under the skin surface (telangiectasia). Unlike the other side effects, telangiectasia does not improve over time.
References
  1. Berman B, and Bieley HC. Adjunct therapies to surgical management of keloids. Dermatol Surg. 22(2), 126-30 (1996).
  2. Uptodate.com. Keloids and hypertrophic scars. Available from: https://www-uptodate-com.eresources.mssm.edu/contents/keloids-and-hypertrophic-scars?source=see_link&sectionName=MANAGEMENT&anchor=H151854186#H151854186. Last retrieved on: 27 November 2017.
  3. Levy LL, and Zeichner JA. Management of acne scarring, part II. A comparative review of non-laser-based, minimally invasive approaches. Am J Clin Dermatol. 13(5), 331-340 (2012).
  4. Ogawa R, et al. Postoperative radiation protocol for keloids and hypertrophic scars: statistical analysis of 370 sites followed for over 18 months.  Ann Plast Surg. 59(6), 688-91 (2007).
  5. Klumpar DI, Murray JC, and Anscher M. Keloids treated with excision followed by radiation therapy.  J Am Acad Dermatol. 31(2 Pt 1), 225-31 (1994).
  6. Kovalic JJ, and Perez CA. Radiation therapy following keloidectomy: a 20-year experience. Int J Radiat Oncol Biol Phys. 17(1), 77-80 (1989).
  7. Ogawa R, Mitsuhashi K, Hyakusoku H, and Miyashita T.Postoperative electron-beam irradiation therapy for keloids and hypertrophic scars: retrospective study of 147 cases followed for more than 18 months. Plast Reconstr Surg. 111(2), 547-53; discussion 554-5 (2003).
  8. Lo TC, Seckel BR, Salzman FA, and Wright KA. Single-dose electron beam irradiation in treatment and prevention of keloids and hypertrophic scars. Radiother Oncol. 19(3), 267-72 (1990).
  9. Enhamre A, Hammar H. Treatment of keloids with excision and postoperative X-ray irradiation. Dermatologica. 167(2), 90-3 (1983).