Applied Evidence

Keloids: Which treatment is best for your patient?

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Other methods may produce suboptimal results. Cryotherapy causes ischemic damage that reduces tumor bulk at least temporarily, but is inappropriate for darker skin due to a high risk of persistent hypopigmentation.1,26,27 Intralesional antifibrotic cytokines, such as interferon, reduce collagen synthesis in vitro,1 but lead to considerable systemic adverse effects including headache, myalgias, and influenza-like symptoms.3,5 Skin grafting is inappropriate as it may lead to keloid wave formation at the graft edges.

CORRESPONDENCE
Stephen P. Daane, MD, 2186 Geary Boulevard #212, San Francisco, CA 94115; stevedaane@gmail.com

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