“Ear-lobe keloids: treatment by a protocol of homeopathic therapy, surgical excision and application of 2-octyl cyianoacrylate”

Background: Keloids are abnormal wound reactions of connective tissue. Auricular keloids can develop as a result of dermal injuries such as ear piercing or skin trauma. Keloids are painful and itchy and, together with their aesthetic discomfort, compromise patients’ quality of life. A wide variety of therapeutic modalities are currently in use. Although the literature on the subject is wide, there is still no effectiveness-established treatment for keloids cure. Our aim is to present the authors’ experience evaluating the combined approach consisted of homeopathic therapy, surgical resection and application of a tissue adhesive to treat ear lobe keloids. Methods: we studied 13 consecutive patients (9 females, 4 males) aged from 15 to 65 years old (mean age: 40 years) with earlobe keloids caused by piercing or surgical injury. The keloids varied in size 2 x 1 to 5 x 3,2 cm. Treatment consisted of six monthly of homeopathic therapy consisting of antihomotoxic preparations acting on evolution of scarring process. In case of satisfied results in terms of redness and stiffness reduction and symptomatic improvement, maintained for at least three months, in the ninth month homeopathic therapy was continued for a six month period, during which intralesional excision of keloid was performed and the defect was closed with a tissue adhesive kept on site for one month. Examination took into account both subjective parameters (pain, itching) and objective parameters (thickness, stiffness, redness, recurrence). Assessment based on clinical observation and photographic documentation. The primary end-point was the number of patients who achieved major flattening of the keloid (defined as a reduction of more than 80% of the keloid) at the time of the study after a minimum follow-up of 24 months after treatment. Results: After homeopathic therapy we observed improvement in both scar stiffness and redness and pain and itching reduction. After surgery we achieved reduction in keloid thickness more than 80%, of the keloid and no relapses at 24 months follow up in all cases. Conclusion: the combination of homeopathic therapy, (well-tolerated especially in young patients), surgical excision and application of 2-octyl Cyianoacrylate, is effective for treatment of earlobe keloid. Even though our proposed therapy is long lasting, on the other hand no relapse was observed. However, studies are needed to evaluate accepted and experimental therapies including larger number of patients.