The Effects of Nicotine in the Treatment of Keloids: A Pilot Study

Dermal keloids are an ongoing problem for genetically predisposed patients. Minor injuries may result in abnormal scarring. Surgical excision results in a return of keloids in 50%80% of cases, and available treatment options, namely steroid injections, radiation therapy and silicone dressings, or pressure garments are not always feasible options. These methods are not hundred percent effective, cannot be used in all persons, have side effects (for instance pain on injection), and are not effective to treat large areas. Even dermal substitutes have resulted in keloid return [1,2]. The ideal treatment should be painless, have few side effects, should be useful in large areas (for instance post burn scars) and should be easy to use maximizing compliance. The cost of the intervention should render it affordable. Steroid injections are painful, cannot be used successfully in large areas or children and there are costs involved. Triamcinolone is not always available as other steroids are purchased in the primary care setting. Radiation cannot be used in large areas and various side effects are associated. It is not safe for use in the very young or fertile age groups. Pressure garments demonstrate inadequate results and compliance. Seldom is the right amount of pressure obtained and loose fitting garments are a problem. Dermal substitutes show high return rates at high cost [3]. The burden of keloids is an ongoing problem. Resources of staff, drugs and dressings are utilized repeatedly with unsatisfactory results for patients and staff alike. The psychological burden on patients, especially young people with keloids is tremendous, leading to loss of adequate social functioning. This in turn may lead to loss of productivity in the school or workplace [4,5]. The study sought to determine if a cream, painless and easy to apply, produced at very low cost may be the answer to this burden. Our hypothesis was that this cream may be applied to large areas post excision, leading to maintenance of normal skin texture. Volume 4 Issue 6 2017