Cryotherapy with silicone products - a noninvasive treatment for keloids - a prospective efficacy assessment study

Keloidal scarring is one of the most frustrating clinical problems in wound healing. Hypertrophic scars and keloid may follow local skin trauma or inflammatory skin disorders like laceration, tattoos, burns, injections, ear-piercing, vaccination, bites, acne, abscess or surgery. Medical advice is sought for relief of pruritus, pain, restricted movement and mainly for cosmetic disfigurement. Comparing with available monotherapies like intralesional triamcinolone, 5 – fluorouracil, bleomycin and other measures, the combination of cryotherapy and silicone products are proved to produce remission, and sustainable, subjective and objective improvement in the treatment for keloids.1
Aim: To analyze the therapeutic outcome and efficacy of combination of cryotherapy with silicone products in the management of keloids.
Materials and methods: Fifty patients were randomly selected for our study and of them 25 patients were given cryotherapy followed by silicone gel application (Group CRSG) and other 25 patients were treated with cryotherapy followed by silicone sheet application (Group CRSS), for a period of 12 weeks. Improvement of the scar was measured with mean volume of reduction, which was assessed individually by two scoring systems, Vancouver scar scale (VSS) and Kavi Prasad scar assessment scale (KPSAS).
Results: There was a significant decrease in patient’s perception of the scar, vascularity, pliability, height, colour and volume at the end of 12 weeks of treatment. The rate of reduction of volume was significantly greater in patients treated with cryotherapy and silicone sheet combination. Hypopigmentation was the most common adverse reaction seen in both groups. The recurrence rate was higher in cryotherapy and silicone gel combination.
Conclusion: Cryotherapy with the combination of silicone products is an excellent mode of treatment with minimal side effects and more valuable in preventing recurrence.