Keloid scars
A keloid is a scar that grows more than it should and extends beyond the boundaries of the original wound.
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Medicines commonly prescribed for Keloid scars
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: TABLET, 8 mgActive substance: dexamethasoneManufacturer: Laboratorios Ern S.A.Prescription requiredDosage form: TABLET, 1 mgActive substance: dexamethasoneManufacturer: Laboratorios Ern S.A.Prescription requiredDosage form: TABLET, 20 mgActive substance: dexamethasoneManufacturer: Tad Pharma GmbhPrescription required
A keloid is a scar that grows more than it should and extends beyond the boundaries of the original wound. It forms because the body produces too much collagen during healing. It is neither dangerous nor pre-cancerous, but it can itch, hurt, restrict movement and cause significant distress about appearance. Treatment is slow and works by combining methods rather than relying on any single one.
How to recognise it
- a raised, firm, shiny, smooth scar;
- pink, red, purple or dark brown depending on skin tone;
- it extends beyond the edges of the original wound — the essential difference from a hypertrophic scar;
- it continues to grow months after the wound has closed;
- it itches, stings or is painful to touch;
- it does not regress with time;
- common sites: shoulders, chest, upper back, earlobe, jawline, over the breastbone.
Keloid or hypertrophic scar
- hypertrophic: raised but confined within the boundaries of the wound; usually flattens and fades within one to two years;
- keloid: grows outside the boundaries, does not resolve on its own and tends to return after excision.
Who is at higher risk
- darker skin: the risk is considerably higher;
- a family or personal history of keloids;
- age between 10 and 30;
- areas under tension: shoulders, breastbone, upper back;
- wounds that became infected or healed under tension;
- severe acne, particularly on the chest and back;
- piercings, especially of ear cartilage and the earlobe;
- burns;
- previous vaccinations and surgery with poor healing;
- pregnancy, which can trigger growth.
When to see a doctor
- the scar is still growing after a month;
- it itches or hurts;
- it restricts movement of a joint;
- it is in a visible place and troubles you;
- it followed a piercing, surgery or a burn;
- you have had keloids before and are due to have an operation: prevention should be planned;
- the scar ulcerates, bleeds or changes appearance — this needs assessment, even though a keloid itself does not become cancerous;
- there are signs of infection.
Treatment
It is worth being frank: keloids are difficult. No method works in every case, improvement is partial, and treatments are combined and continued for months. The earlier you start, the better the result.
- corticosteroid injections — the reference treatment. Repeated every 3–6 weeks over several sessions; they flatten the scar and relieve the itch;
- silicone sheets and gels — these must be used for 12–24 hours a day for 3–6 months. They work, but only with that consistency;
- pressure therapy — pressure garments or clips, particularly useful on the earlobe after excision;
- cryotherapy, often combined with injections;
- 5-fluorouracil or bleomycin injections, alone or with steroid;
- vascular laser for colour and itch, and fractional laser for texture;
- surgical excision — never on its own, because keloids recur in most cases and usually come back larger. It is always combined with injections, pressure therapy or post-operative radiotherapy;
- superficial radiotherapy within 24–48 hours of surgery, in selected cases;
- sun protection: sunlight darkens the scar persistently.
Prevention
For someone prone to keloids, this is worth more than any subsequent treatment.
- avoid unnecessary surgery and piercings, particularly on the chest, shoulders and ears;
- tell your surgeon about your history before any procedure;
- care for the wound so it does not become infected, and avoid tension across it;
- start silicone as soon as the wound is closed, at around 2–3 weeks, and continue for months;
- paper tape over a fresh scar to reduce tension;
- strict sun protection for at least a year;
- treat chest and back acne promptly;
- do not scratch or pick at forming scars.
Common questions
Can it turn into cancer? No. But a lesion that ulcerates or bleeds should be assessed.
Will it go on its own? No. Unlike a hypertrophic scar, a keloid does not resolve spontaneously.
Can I just have it surgically removed? No. Surgery alone has a very high recurrence rate and the keloid often returns larger.
Do scar creams work? Silicone-based ones have supporting evidence. Vitamin E and onion extract have little.
If I had one, will I get more? The predisposition remains. That is why any procedure should be planned in advance.
Online consultation
In an online consultation the doctor reviews photographs, distinguishes a keloid from a hypertrophic scar — which changes both outlook and treatment — proposes a combination of methods with realistic timescales and, if you are due surgery, works out a prevention plan with you.
This material is for information only and does not replace a medical consultation.
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Reviewed on Jul 26, 2026
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