Management of keloids in the United States, 1990-2009: an analysis of the National Ambulatory Medical Care Survey.

BACKGROUND

Keloids can cause significant morbidity during wound healing, but the most common current treatment practices for keloids are not well-established.

OBJECTIVE

To determine the main treatments used for keloids in the United States and demographics of patient visits for keloids.

METHODS

The National Ambulatory Medical Care Survey for 1990-2009 was queried for visits with a diagnosis of keloids. Leading medical and procedural treatments, patient demographic characteristics, physician specialties, reasons for visit, and comorbidities were assessed.

RESULTS

There were an estimated 427,500 visits per year for keloids, with a slight decline in frequency of visits over time (p = .001). Triamcinolone was the leading medical treatment, and excision or destruction of a lesion was the leading procedural treatment. Sixty-two percent of patients were female, and 23.7% were African American. Mean age was 36.6. Dermatologists managed slightly more than half of visits, and plastic surgeons were second most used.

CONCLUSIONS

Keloids are managed using a variety of treatments, primarily triamcinolone and excision or destruction of a lesion. High-quality evidence is lacking for the efficacy of most existing keloid treatments. New treatments that improve on the present standard of care would improve outcomes.