Myderma and Keloid Treatment
There is no evidence that "Myderma" is an effective treatment for keloids, and it is not mentioned in any current clinical guidelines or research literature for keloid management.
Established First-Line Treatment
The evidence-based approach to keloid treatment centers on intralesional corticosteroids, not Myderma:
Triamcinolone acetonide (10-40 mg/mL) is the most commonly used and guideline-recommended first-line treatment for keloids, with higher concentrations (40 mg/mL) recommended specifically for keloids 1.
Triamcinolone acetonide demonstrates 50-100% regression rates, though recurrence occurs in 33% at 1 year and 50% at 5 years 2.
Meta-analysis confirms that triamcinolone acetonide significantly reduces keloid size compared to untreated controls and shows superior effectiveness compared to silicone gel sheets, verapamil (in terms of vascularity and scar pliability), and cryotherapy (for scar thickness reduction) 3.
Critical Considerations for Patients with Keloid History
For patients with a personal or family history of keloids, prevention is the best strategy, and they should be cautioned about any procedures causing skin trauma 1.
Genetic predisposition plays a strong role, with keloid tendency being genetically transmitted, meaning patients with this history face significantly elevated risk with any skin trauma 4.
Body piercings trigger keloid formation at a rate of approximately 2.5% in ear piercings, with higher infection rates (18.4%) in professional shops potentially leading to keloid formation 4.
Treatment Algorithm When Keloids Develop
If keloids have already formed despite preventive measures:
Start with intralesional triamcinolone acetonide (10-40 mg/mL) as monotherapy 1.
Monitor for local adverse effects including atrophy, pigmentary changes, telangiectasias, and hypertrichosis, as well as systemic absorption with repeated injections 1.
If triamcinolone alone shows inadequate response or excessive side effects, consider combination therapy with 5-fluorouracil, which has been shown to be more effective with fewer undesirable effects compared to either agent alone 2.
Triamcinolone combined with verapamil achieves statistically significant overall improvements with long-term stable results 2.
Common Pitfalls
No single modality is completely effective for keloids, and patients must understand that keloids will only improve, not disappear completely 5.
Recurrence rates are high regardless of treatment modality, and patients should be counseled about this reality before initiating therapy 5.
Laser therapy alone carries a high recurrence rate and should be combined with triamcinolone acetonide injections for better outcomes 2.
Watch for infections during treatment, which can be managed with standard topical or systemic antibiotics 1.