REVISITING RADIATION THERAPY FOR KELOID SCARS

In each edition, Modern Aesthetics^® asks top aesthetic physicians about the newest devices in their practices. This month, MARK S. NESTOR, MD, PhD, FAAD talks about the SRT-100 SUPERFICIAL RADIATION SYSTEM from Sensus Healthcare.

THE SRT-100 IS A NEW TECHNOLOGY TO DELIVER AN ESTABLISHED TREATMENT. WHY THE RENEWED INTEREST IN SUPERFICIAL RADIATION?

Dr. Nestor: Radiation therapy dates back to the late 1800s and early 1900s, when it was used by European and US dermatologists to treat many dermatologic conditions that at that point really had no treatment, including acne, other types of inflammatory skin diseases, scars, and other conditions.

Radiation therapy fell out of vogue because it became difficult to replace old technology. Some studies that were performed by the American Academy of Dermatology in the 1970s found that the majority of dermatology offices had radiation therapy equipment in their office, and it was even being used by more than 50 percent of dermatologists.

The SRT-100 is the innovation that was needed in technology to allow radiation therapy to move into the 21st century and provides a computerized system that has significant safety thresholds built in to treat patients who are appropriate and can benefit from this treatment in a safe and effective manner.

WHAT ARE CHALLENGES OF KELOID MANAGEMENT? HOW DOES SRT-100 ADDRESS THESE?

Dr. Nestor: We see keloids all the time. Certain patients, especially patients of color, are more prone to the development of keloids in certain locations, especially areas such as the chest, back, and other areas. We've always had a problem with keloid recurrence. Most studies show that keloids can occur in up to 90 percent of cases when they are excised.

Non-invasive modalities—like intralesional triamcinolone or 5FU—are not very effective. We have various types of techniques that have some efficacy.

The use of an adjuvant radiation therapy has changed the way we look at recurrences of keloids. Studies show that you can reduce recurrences up to 90 percent by just doing a few short treatments of radiation therapy after excision of a keloid. This has in large respect revolutionized how we can look at the aspect of removing keloids and reducing recurrences in these patients.

WHAT ARE KEY FEATURES OF THE SRT-100 SYSTEM?

Dr. Nestor: The advantage of SRT-100 is that you can program and utilize the device to treat what is optimal for reduction of keloids. Normally what's optimal is a few short high-energy treatments—probably three—very quickly after excision. The device allows us to do this in a safe and effective manner. My experience is that patients heal beautifully from this, and we consistently see the aspect of either a very, very limited or no recurrence of the keloid.

For the keloid patients who have been through many, many treatments and having excision after excision, it's opened up a new world for them. Keloids cannot only be disfiguring, they can be painful, and the ability for us to remove a keloid and not have this recurrence is a real lifechanging event for these patients.