Steroids have been long used in treatment of various skin disorders. Injecting steroids directly inside the keloid tissue, known as intra-lesional injection, is a commonly used method of treating small keloids. This treatment however, is only partially effective. Triamcinolone acetonide is the most commonly used drug for treatment of keloids. Dr. Sexton reported the efficacy of intra-dermal injection of this fluorinated prednisolone derivative in 1960 . Applied intralesionally, triamcinolone acetonide is one of the most widely used treatments for keloids, whether alone or in combination with another type of treatment. Steroid injections are not as effective as we would like them to be. About one third of patients give up treatment because of intense pain. About 15% of patients report worsening of their keloids following steroid injections.
Keloid scars a challenging to remove, as they may recur despite treatment at some point in the future. These types of scars are more common around the ears or chest, especially in darker skinned individuals. The mainstay of keloid scar therapy is both steroid injections and plastic surgery. Commonly, plastic surgeons will inject a keloid scar before, during, and after the plastic surgery. Other treatments for aggressive or extensive scarring include low-dose radiation, silicone, pressure, or skin grafts among other things. Only after a comprehensive evaluation can a plastic surgeon help determine appropriate treatment options for you. Best of luck.
Mercury pigments are most commonly associated with skin reactions. These reactions may occur years after you get your tattoo. Often the metal alone doesn’t cause a problem, but it is when the pigment is exposed to cross reactants that a reaction can occur. Chemicals like the preservative thimerasol (used as a preservative in contact lens solutions and eye drops), mercurochrome, and some vaccines, may cause a reaction in your tattoo. If you think you have a thimerasol allergy, you may want to explore non-metallic pigments. Also, some organic compounds have been known to cause phototoxic reactions when exposed to sunlight.