Another issue with usage of intra-lesional steroids is the size, length and thickness of the needle used to inject the keloid lesions. Some physicians falsely believe that a large and thick needle should be used to inject large keloid lesions. This belief comes from the fact that injecting some old and dense keloid lesions is a rather difficult task. In treating keloid lesions, the smaller and thinner the needle is, the less damage it causes to the keloid tissue. Dr. Tirgan only uses the smallest and thinnest needles, those that are used to inject insulin under the skin. With this method, Dr. Tirgan is able to inject any keloid.
Keloids are an important medical problem which are often under appreciated by the medical community. Dr. Michael Tirgan has spent many years evaluating and treating patients with keloids on different regions of the body. The Atlas of Ear Keloids presents new insights into the natural history of keloids and provides a perspective that many of the standard surgical approaches may actually lead to progression of these tumors on ear. He presents good examples of an alternative treatment with cryotherapy that has convincingly eliminated some of the most troublesome keloids on ear. This book will provide valuable information to patients with keloids on ear and to medical professionals that treat these lesions.