Extracorporeal Shockwave Therapy for Treatment of Keloid Scars
Title: Extracorporeal Shockwave Therapy for Treatment of Keloid Scars
Authors: Ching-Jen Wang, M.D., Jih-Yang Ko, Wen-Yi Chou, Jai-Hong Cheng, Yur-Ren Kuo
Many methods of treatment were proposed for the keloids including steroid injection, surgical excision, radiation therapy, laser therapy, pressure therapy, cryotherapy, silicone gel, 5-flurourasil, interferon, retinoid and combined therapies. Each modality achieved some successes, but none showed universal results. However, a study has shed light on the potential benefits of shockwave therapy (ESWT) as an effective alternative treatment for keloid scars. The study compared the histological effectiveness of ESWT with the commonly used method of intralesional steroid injection.
The results demonstrated that ESWT was equally effective or even superior to steroid injection in reducing keloid scars. ESWT significantly reduced collagen content, including types I and III collagen, as well as Masson’s Trichrome staining. This reduction in collagen was attributed to the increased activity of MMP-13, an enzyme responsible for collagen degradation. Consequently, the keloid bundles became flatter, leading to improved scar appearance.
In addition to reducing collagen tissue formation, ESWT also exhibited other favorable effects. It increased apoptosis, or programmed cell death, in the keloid scar tissue, and decreased proliferation, further inhibiting scar formation. The study highlighted the low complication rate associated with ESWT treatment, further emphasizing its potential as an alternative method for keloid scar management.
While steroid injection remains the most effective treatment for keloid scars, this study suggests that ESWT can be considered equally effective or even superior. By inhibiting collagen fiber formation through increased enzyme degradation and apoptosis, ESWT holds promise as a viable treatment option for patients with keloid scars.