Study Finds Racial Variation in Keloid Treatment
Key Takeaways
- A large TriNetX analysis found racial differences in treatment patterns among adults diagnosed with keloids.
- Black, Asian, and Other-race patients were generally more likely to receive intralesional injections, excision, repair procedures, and tacrolimus, whereas White patients were more likely to receive destruction procedures, imiquimod, and fractional ablative laser treatment.
- Treatment-pattern differences were observed, but could not determine whether access, insurance coverage, clinician decision-making, disease severity, or other factors caused those differences.
An electronic health record analysis found differences in how keloids are treated across racial groups.
In a Letter to the Editor published in the Journal of Drugs in Dermatology, investigators evaluated treatment patterns among adults with keloids using the TriNetX Research Network. The authors identified patients aged 18 to 89 years with a keloid diagnosis and categorized them as Black or African American, Asian, White, or Other Race. The analysis included 45,191 Black patients, 16,179 Asian patients, 99,076 White patients, and 8,334 patients categorized as Other Race. Data were collected May 2, 2025, and included de-identified electronic medical records from nearly 144 million patients across 102 health care organizations.
Keloid Treatments Differed Across Racial Groups
The authors focused on medical and procedural interventions occurring within 1 year after diagnosis, including intralesional injections, destruction procedures, radiation treatment, excision, repair procedures, fractional ablative laser treatment, tacrolimus, and imiquimod. Patients who received the treatments before their keloid diagnosis were excluded to reduce potential confounding from treatment for other conditions.
According to the data, Black, Asian, and Other-race patients were generally more likely to undergo intralesional injections, keloidectomy, and repair procedures and to receive tacrolimus. White patients were more likely to undergo destruction procedures and laser treatment and to receive imiquimod.
The authors noted that these treatment differences could reflect factors including access to care, insurance coverage, or clinician decision-making. However, the analysis does not establish why the observed differences occurred or whether they affected recurrence or other clinical outcomes.
“Further research is needed to assess how these patterns impact clinical outcomes and long-term disease burden,” the authors wrote.
Source
Adler R, et al. Journal of Drugs in Dermatology. 2026;25(9):9651.