Ear keloid treatment using subepidermal excision-assisted electrophotobiomodulation

Abstract

Background Keloids are challenging problems that have an aesthetic and psychological impact on patients who are genetically susceptible, especially in exposed areas. Moreover, treatment modalities are known to have a high incidence of recurrence. Aim We present our experience in subepidermal excision combined with E-light therapy (electrophotobiomodulation) in the treatment of ear keloids. Patients and methods Thirty-five patients who were presented with ear keloids were included. Under local anesthesia, a flap of keloid epidermis and a thin layer of the scar underneath were raised from the fibrous keloid core which, in turn, was extirpated leaving a thin margin of scar tissue (subepidermal excision). 2 weeks later after complete healing, all patients were subjected to a combination of radiofrequency (RF) and intense pulsed light (IPL) sessions (E-light). The outcome was assessed by the incidence of keloid recurrence at any time within the 2-year follow-up. Result The age of the patients ranged from 12 to 52 years with a median age of 34 years. There were 25 females (71%) and 10 males (29%). The average number of E-light therapy sessions was 6 (range 4–8 treatment sessions) at 4-week intervals. Keloid size had an average of 1 × 3 cm. In the 2-year follow-up, only two cases reported keloid recurrence. Of the patients, 33 did not report recurrence with a success rate of 95%. Conclusions Subepidermal keloid excision with a combination of radiofrequency and intense pulsed light is a promising multimodality treatment for ear keloids.