Question: I am a 26-year-old black woman. All through high school, I begged my mother to let me get my ears pierced. She said to wait until I graduated from college and was on my own. I did. On each ear, the piercing left a huge scar. The doctor called it a keloid. What are keloids and what is their treatment?

Answer: Keloids are scars that form far too much scar tissue. The result is an unsightly, overgrown and sometimes disfiguring scar. Scars from surgery, from an inadvertent cut and from procedures as innocuous as ear piercing can become keloids. People of Asian and African descent are particularly vulnerable to developing such scars.

I don't want to discourage you, but keloid treatment often involves a recurrence of a keloid scar. Plastic surgeons and dermatologists are the doctors to consult for possible correction.

I'll give you some examples of how keloids are treated:

One way is injecting them with potent cortisone drugs, such as triamcinolone. A good response occurs in 70 percent of patients, but the recurrence rate is also high.

Excision of the scar followed by triamcinolone injections into the newly healing tissues is another method.

Silicone gel sheeting can reduce the size of a keloid. The sheeting is cut to cover the keloid and is taped in place. It's left on the keloid for up to 24 hours, then washed and reapplied. The sheet is replaced about every two weeks.


Freezing the keloid, cryosurgery, is another way to deal with keloids. The doctor freezes the keloid, then lets it thaw and repeats the procedure two more times. The process is done on a monthly basis until the keloid has shrunk.

Radiation after surgical excision is another way to remove keloids.

Use of a laser in combination with cortisone injections has its proponents.

Pressure earrings called Zimmer splints can compact the keloid to minimize it. The splints look like ordinary earrings.

There is no lack of procedures to deal with keloids. The problem is finding the right one for the individual. Let the plastic surgeon or dermatologist suggest the best one for you.


Question: I have taken the osteoporosis drug Fosamax for five years. Is it lifelong treatment? Several women I know have told me the drug can have dangerous complications. I'm afraid to take it much longer.

Answer: The drug family to which Fosamax belongs is called bisphosphonates. These medicines are among the best and most effective treatment for osteoporosis. Bisphosphonates have, in rare instances, caused death of a piece of the jawbone and have led to some femoral (thigh bone) fractures. Those complications are most unusual. The complications of not treating osteoporosis are more intimidating.

A certain and universally adopted answer to your question isn't possible at the present time. Many doctors stop bisphosphonate treatment after three to five years if the woman does not have a high risk for breaking bones. Some of these doctors discontinue therapy only temporarily.

For women whose chances of suffering a broken bone are great, treatment is usually continued indefinitely.


Question: What is the name of the blood test that detects ovarian cancer? My best friend had ovarian cancer and died. Another friend said she wouldn't have died if she had had the blood test.

Answer: A blood test for the early diagnosis of ovarian cancer doesn't exist. I think your friend was talking about the test called CA-125. It's not a reliable test for the diagnosis of this cancer. It gives too many false results. It is used, however, to monitor the effectiveness of ovarian cancer treatment.

Ultrasound pictures of the ovary taken with the ultrasound camera located in the vagina are helpful in arriving at a diagnosis.

The unfortunate thing about ovarian cancer is that it is silent in its early stages, when it can be successfully treated.


Question: My husband was diagnosed with ataxia. What is it?

Answer: Ataxia is uncoordinated muscle movement. For most ataxia patients, it indicates a stumbling walk. I have to apologize to you. I can't go much further than the unsatisfactory answer I have given you. That's because there are many different kinds of ataxia. If your husband's doctor is able to denote the kind of ataxia your husband has, I can give you better information.
