Understanding keloid treatment
Keloids form when healing overshoots, producing excess collagen that extends past the original injury. They are more common on the chest, shoulders, earlobes and jawline, and there is often a family tendency.
Intralesional steroid injection is the mainstay, flattening and softening the lesion over a series of sessions. Adjuncts such as silicone, pressure therapy or cryotherapy may be added.
Excision on its own has a high recurrence rate, often with a larger keloid, which is why a combined and staged approach with realistic expectations is standard.
This may suit you if
- Raised, firm scars extending beyond the original wound
- Keloids that are itchy, tender or growing
- Earlobe keloids after piercing
- Patients with a history of keloid formation planning a procedure
What happens at the clinic
- 1
Assessment
The scar is examined and distinguished from a hypertrophic scar, which behaves and responds differently.
- 2
Injection
Intralesional steroid is injected into the lesion. The injection can be uncomfortable and takes only a few minutes.
- 3
Repeat sessions
Injections are repeated every three to four weeks, with the lesion assessed for flattening and softening at each visit.
- 4
Adjuncts and prevention
Silicone, pressure therapy or other measures are added where useful, and prevention advice is given for future wounds.
Aftercare
- Avoid further trauma, piercing or tattooing at the site
- Use silicone gel or sheeting if prescribed, consistently
- Protect the area from sun to reduce discolouration
- Report any regrowth early rather than waiting
Possible side effects
- Skin thinning or lightening at the injection site
- Visible small vessels after repeated injections
- Recurrence, particularly after surgery alone
- Incomplete flattening in long-standing keloids