A Short Educational Intervention Measurably Benefits Keloid-Prone Individuals’ Knowledge of Prevention and Treatment

April 2013 | Volume 12 | Issue 4 | Original Article | 397 | Copyright © April 2013

Sarah Y. Lee BA,a Judy H. Borovicka MD,a Jaimee S. Holbrook MD,a Mary J. Kwasny ScD,b Dennis P. West PhD,a and Roopal V. Kundu MDa

aDepartment of Dermatology, bDepartment of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL

BACKGROUND: The Internet is a commonly utilized health information resource that provides access to information of varying quality.
OBJECTIVE: We sought to evaluate the use of the Internet as a health information resource within a keloid patient population and the effects of an educational intervention on patient knowledge about keloids.
METHODS: A consecutive convenience sample of subjects completed a questionnaire on keloid-related Internet use and on personal and family history of keloids. Participants listened to a short educational intervention on keloid-related topics followed by assessment of relevant knowledge at baseline, immediately postintervention, and 3 months after the intervention.
RESULTS: Among 40 participants, 55% reported having used the Internet to obtain keloid-related information. Subjects who had used the Internet to obtain keloid-related information had baseline knowledge similar to those who had not. When subjects were assessed immediately and 3 months postintervention, the intervention improved knowledge that not all raised scars are keloids, that keloids are not cancerous, and that certain areas of the body are more prone to keloid formation. The proportion of subjects who reported being less likely to obtain piercings or tattoos because of the intervention was 80% and 75%, respectively.
LIMITATIONS: This study was performed at a single academic center.
CONCLUSION: The Internet is a commonly used information resource for keloid-prone individuals, but keloid-related knowledge was not greater among Internet keloid-related information seekers. A very short educational intervention benefits keloid-prone individuals by improving knowledge about keloid prevention and treatment and by discouraging them from obtaining piercings and tattoos.

J Drugs Dermatol. 2013;12(4):397-402.


Of the estimated 79% of US adults who use the Internet, 80% use the Internet to search for health information.1 Given the greater prevalence of Internet use among younger Americans, the proportion of adults who use the Internet to find health information is likely to increase in the future. The quality of health information on the Internet varies greatly depending on the specific source of information and the topic researched,2 but a recent assessment of dermatologic information on the Internet found the information to be relatively accurate and complete.3 The Internet is an effective medium through which physicians can disseminate educational content to patients4-5 and clinicians6 alike. On the other hand, the Internet also provides an avenue for patients and commercial interests to share and access dubious health information, including information on ineffective or even harmful self-treatments.7-10
Because of the cost of professional treatment and the persistence of keloid-associated symptoms (eg, pruritus, pain), keloids may be particularly attractive as the target of Internet health information searches. The effect of Internet use on knowledge about keloids among prone individuals has not been examined. In addition, there has been no investigation to date on assessing keloid knowledge or on improving keloid knowledge through an educational intervention. Given the importance of initiating professional treatment soon after scar development for optimal treatment outcomes and the potential for self-treatments to cause scar enlargement and worsening of associated symptoms, patient education is an important component in the care of keloid-prone individuals.



Between August 2010 and June 2011, 40 subjects were recruited from consecutive patients seen for keloids at Northwestern University’s dermatology clinic in Chicago, IL, and from the general population by advertisements in a local newspaper and Internet classifieds. Eligibility criteria required that subjects were older than 18 years and had a clinical diagnosis of keloid scarring made by a dermatologist at Northwestern. Participants received a $10 gift card for their participation. The study was reviewed and approved by the Northwestern University Institutional Review Board (approval number STU00032316). Signed informed consent was given by each subject before participation. The clinicaltrials.gov registration number is NCT01176877.

Study Design

Subjects were administered a self-report questionnaire that collected demographic data and information about personal and