23 May 2015
RHINOPLASTY OVERVIEW – PART 3
Dr. Oleh Slupchynskyj is a Double Board Certified Plastic Surgeon and renowned Keloid Specialist offering a variety of proven successful surgical and non-surgical treatments for keloid scaring, including Cryotherapy Keloid Treatment.
A keloid is abnormal tumor-like scar tissue, which grows to excess and beyond the borders of the injury or trauma site. Although there is no universally accepted treatment of keloids, Cryotherapy has become popular as a non-surgical treatment of keloids scarring. Cryotherapy, also known as cryosurgery, is used by surgeons and dermatologists for treatment of a variety of benign and malignant lesions. The mechanism of Cryotherapy is to induce necrosis (death) of the tissue following treatment. There is an acute freezing and subsequent thawing of cells. In other words, Cryotherapy is almost identical to frostbite, which can occur in individuals that expose their extremities to bitter cold temperatures such as mountain climbers. Cryotherapy Keloid Treatment essentially "frostbites" the tissue exposed; as the tissue thaws, it dies and leaves the surrounding living tissue to re-epithelialize.
Benefits of Cryotherapy Keloid Treatment
The advantage of Cryotherapy is its ease of use; it is non-surgical and usually less costly than surgical procedures. Cryotherapy treatment is a good option for smaller, sessile keloids yet there still are many risks to consider with this type of treatment. It should be noted that Cryotherapy Treatment of Keloids is not the "one-size-fits-all" solution to keloid scar treatment, though it has been heavily marketed and hyped as such. Each patient must be evaluated on an individual basis and treated appropriately with either non-surgical or surgical intervention, with or without adjunctive therapy.
Risks and Complications of Cryotherapy Keloid Treatment
The risks for Cryotherapy Keloid Treatment include hemorrhage, infection, excessive granulation tissue, milia, hyper pigmentation, and change in sensation. Permanent complications can include atrophy, scarring, extensive hyper pigmentation, ectropion formation, and of course, recurrence of keloids. Cryotherapy is not a good option for larger and also massive, polyploidy keloids such as the one shown in the picture below.
Clinical Study: Keloid Excision Surgery Plus Radiation Outperform Cryotherapy
In a recent scientific keloid study, "Surgical excision and immediate postoperative radiotherapy versus cryotherapy and intralesional steroids in the management of keloids: a prospective study trial". Emand M, et, al. Med Princ Pract 2010:19(5):402-5, showed that patients treated with cryotherapy experienced more side effects, prolonged course of recovery, a higher recurrence rate and less satisfaction than patients treated with surgery and an adjunct treatment with radiation. The study concluded that excisional surgery plus radiation is a much better overall treatment for keloids resulting is less recurrence and ensuing complications. That being said however, Cryotherapy Treatment is still a good option for very small to small, early keloids and should be clearly be offered as an option to those who would benefit most from this treatment.