I will preface this article by saying keloids are not specific to the Black community. However, Black women and women with darker skin are more prone to getting them than women with fairer skin or of different ethnicity.
I have keloids from different experiences in my life, such as falling on asphalt, burning myself with hot wax and, of course, hair removal. I speak from my experience only. Recently, I have started the journey of ridding myself of the keloids and the leading cause for them, which for me is hair removal. I am sharing my experience since I could not find the perspectives of people who had used erbium. Instead, I only saw scientific articles. Those articles were helpful, but I wanted to hear what an actual person went through. I am sharing this article because those who suffer from prominent keloids understand the want to make them smaller but not at the expense of scarring the skin even more.
This article discusses the process of choosing erbium, my treatment experience, tips, and results.
Why Erbium: When I started waxing my face, I would see bumps appear on my skin. They were slightly raised, but they would go down over time. As I continued to wax, the nodes grew larger. After a year, I was at the point where I couldn’t avoid it, and I had to seek treatment because I could not tell whether they were ingrown hairs or cystic acne; all I could see were small peaks on my face. My first dermatologist thought they were cystic, so she prescribed Tazorac. That did nothing but help when I would get a breakout every once in a while. After a few months, I decided to go to another dermatologist and seek a second opinion.
Initially, they prescribed an antibiotic and cortisone steroid injections, but I did not see any changes. We figured out that the bumps were keloids and not cystic acne. We continued with the injections, but there was no improvement, so my dermatologist suggested adding laser treatment to accompany the injections. As I reflect on that moment, I realize I was still waxing, which could have led to me not seeing a change from the injections. The laser treatment is called erbium, and its purpose is to penetrate the keloids and reduce their size.
Cost: I purchased a package of four sessions. The office told me people usually see results after 3–6 sessions, but results are not guaranteed, and additional sessions may be needed. At this point, I was frustrated and was willing to try anything.
In addition to the erbium and injections, I also paid for laser hair removal to reduce hair growth and the probability of keloids in the future. The cost of the packages will vary based on your dermatologist, but with the injections, erbium, and laser hair removal, the price for me was around $4,000.
What to Expect During the Treatment and Immediately After: Before I received the treatment, the nurse put a numbing cream on my skin and had me sit for about 15 minutes so it could penetrate. After, they took me to a different room where the laser was located. They put goggles on my eyes and laid me, so I was flat on my back. After that, they used alcohol to clean the numbing cream off my face. I could hear the laser machine humming as it warmed up. And then, zap. It hurts. I call myself the waxing queen but to me, waxing is nothing compared to laser. It may be because I am used to the feeling of wax versus the laser, and I have to get accustomed to it. However, it is not for the faint of heart and if you think you have a low pain threshold, I recommend dong a test run before the full session to see if you can handle it. Even with the numbing cream for my erbium treatments, my eyes still watered.
After the treatment, my skin was red and swollen, where she lasered my keloids, but the swelling decreased after a few hours. Once the swelling went down, I was left with scabs. The scab looks like little black pinpricks grouped together in a rectablge. After a few days, the scab falls off, and your skin is exposed again.
My doctor gave me an anti-inflamation cream with Aquaphor to calm the skin. I think it helps, and the scabs did not stop me from using my everyday cleanser or putting on makeup, but I was careful with applying things to my face to ensure the scabs did not fall off before it was time.
Long-term Side Effects and Results: In the first session, we used a lower heat setting for the erbium, but during the second treatment, she raised the heat setting, and the scabs were a bit darker than before. At first, I was nervous, but once the scab fell off, the pigment returned after a day or so. My skin was slightly tender, more from the injections than the laser, but the pain went away after the day of treatment.
As of the publishing of this article, I have received two erbium and one laser hair removal treatment. I schedule my erbium and laser treatments to be about three weeks apart, so my skin has time to heal, but I can still be a little aggressive with seeing results.
I didn’t start seeing results until after my second treatment. The keloids are significantly smaller. They are still visible, but they are flatter and softer. I monitor them daily, and the size fluctuates, but they are smaller overall. As far as the hair, I only have had to cut a few hairs, but the area is bare for the most part. The investment has been worth it, but I have seen a few small red flags and communicated them to my doctor.
Tips: I was skeptical at first because I had tried so hard to get rid of the keloids, but I do think the treatments are working. I strongly suggest using sunscreen whenever you think you’ll be in the sun for more than 15 minutes, even in winter. Additionally, listen to the skin care treatment your dermatologist suggests you do in between appointments.
Document the journey and take photos so you can show the progression if an issue arises. I cannot stress enough how important it is to have a doctor and nurse staff that care about your skin journey and listen to you when you see something wrong. At the end of the day, it is your skin, and these treatments are not cheap, so you want to ensure they are effective and your concerns are addressed. Also, do your research. Because your doctor may look like you, they may not offer the care you need, so be sure to be thorough. I have had experiences with Black dermatologists that did not listen or were dismissive. All dermatologists I have been to so far have been Black, but I feel most comfortable with my current one.
Lastly, I recommend only using what your doctor prescribes because there may be chemicals in some of your facial products that increase skin sensitivity. For example, I have an ingrown hair serum that I can’t use because it contains mild acid.
I hope this article is helpful to anyone who is thinking about using erbium to reduce the size of their keloids. Again, please discuss this with your dermatologist to determine if this is the right path for you because you may need to consider alternative options.
