Keloids are raised, firm scars that grow beyond the boundaries of the original injury. Unlike normal scars, which gradually settle over time, keloids continue to expand and may become thick, itchy, tender, or cosmetically distressing.
They can develop after relatively minor skin injuries such as acne, insect bites, ear piercings, surgical wounds, or even small cuts. Some individuals have a stronger tendency to form keloids, particularly those with darker skin types or a family history of similar scarring.
Keloids are not harmful, but they can be uncomfortable and may affect confidence, particularly when they occur on visible areas such as the chest, shoulders, earlobes, or jawline.
Why do keloids form?
Keloids occur due to an overactive healing response in the skin. Instead of producing just enough collagen to repair the injury, the body continues to produce excess collagen, leading to a thickened, raised scar that extends beyond the original wound.
Available treatments
Keloids can be challenging to treat, and recurrence is common. Management is usually tailored to the individual and often involves a combination of treatments to achieve the best outcome.
Corticosteroid injections
These are one of the most commonly used treatments. Steroid injections help to reduce inflammation, flatten the scar, and improve symptoms such as itch and tenderness. A series of treatments is usually required.
Silicone gel or silicone sheets
These can be applied at home and may help soften and flatten scars over time. They are particularly useful in early or smaller keloids.
Laser treatment
Vascular lasers (such as pulsed dye laser) can help reduce redness and, in some cases, improve the texture of the scar. Multiple sessions are usually needed.
Cryotherapy
Freezing the keloid with liquid nitrogen can reduce its size. This is often used for smaller lesions or in combination with other treatments.
Surgical removal
Excision may be considered for selected keloids, particularly large or symptomatic ones. However, surgery alone carries a high risk of recurrence, so it is almost always combined with other treatments such as steroid injections or radiotherapy.
Pressure therapy
Pressure earrings or garments may be recommended for keloids in specific areas, particularly the earlobes, to reduce recurrence after treatment.
Radiotherapy (selected cases)
Low-dose radiotherapy may be used after surgical removal in resistant cases to reduce the risk of recurrence. This is carefully considered and reserved for appropriate patients.
What to expect from treatment
Keloids can usually be improved, but they are rarely “cured” completely. The aim of treatment is to:
- Flatten and soften the scar
- Reduce symptoms such as itch or pain
- Improve overall appearance
Multiple treatment sessions are often required, and long-term follow-up may be needed to minimise recurrence.
Frequently Asked Questions
Are keloids dangerous?
No. Keloids are benign (non-cancerous) growths of scar tissue. They do not turn into skin cancer.
Will a keloid go away on its own?
Keloids do not typically resolve without treatment. In some cases, they may stabilise over time but usually persist.
Why did I develop a keloid?
Some people are genetically more prone to keloid formation. Even minor skin injuries can trigger them in susceptible individuals.
Can keloids come back after treatment?
Yes. Recurrence is common, particularly if keloids are treated with surgery alone. This is why combination therapy is often recommended.
Are treatments painful?
Some treatments, such as injections or cryotherapy, can cause temporary discomfort. This is usually brief and manageable.
Can I prevent keloids?
If you are prone to keloids, it is best to avoid unnecessary skin trauma such as cosmetic piercings or elective procedures. Early treatment of new scars may help reduce the risk of keloid formation.
Do silicone gels really work?
They can be helpful, particularly in early or smaller scars. They are safe and often used as part of a broader treatment plan.
When should I seek treatment?
Early assessment is helpful. Treating a keloid in its early stages often leads to better outcomes than waiting until it becomes large or symptomatic.