TL;DR

Keloids form when your skin overproduces collagen after injury, growing beyond the original wound.
Effective treatment usually requires medical interventions such as steroid injections, lasers, or cryotherapy.
Complete removal isn’t always possible, but keloids can be flattened, softened, and kept from regrowing with proper care and consistent follow-up.

If you’ve found your way here, you’re likely frustrated, self-conscious, or simply tired of that stubborn scar that won’t flatten no matter how many creams you try. Keloids are far more common than you might think, and you’re not doing anything wrong.

Through this article, we want to help you understand exactly what’s happening, why your scar behaves the way it does, and, most importantly, what we can do about it.

The good news? While keloids are notoriously stubborn, they are absolutely treatable with the right approach.

Book a Consultation with us today!

What causes keloid scars?

Keloid scars form because your skin is trying a little too hard to heal. After any skin injury—be it a cut, acne breakout, piercing, surgical wound, or burn—your body kicks into healing mode by producing collagen, the protein that gives skin its structure.

In some individuals, this process goes into overdrive. Instead of stopping when the wound is repaired, the body keeps producing collagen, causing the scar tissue to grow beyond the original injury. This results in a firm scar that may continue to thicken over time.

Keloids are more common if you have certain risk factors:

Family history of keloids
Darker skin tones (Fitzpatrick skin types IV-VI)
Younger age (typically between 10 and 30 years old)
High-tension areas on the skin (e.g., chest, shoulders, earlobes, jawline)

Types of keloids

Type	Description
Highly Vascular Keloids	Appear red or pink due to a rich blood supply; often respond well to vascular laser treatments.
Newer (Early) Keloids	Formed within the first year of injury, often softer and more responsive to early intervention treatments like steroids and silicone therapy.
Older (Mature) Keloids	Long-standing, firmer, and often more fibrous; may require combination therapies for best results.
Earlobe Keloids	Commonly caused by piercings; often treated with a combination of excision, pressure therapy, and steroid injections.

Know your keloid type? Speak to us today!

What's the difference between hypertrophic and keloid scars?

While both hypertrophic scars and keloids are raised, they behave quite differently.

Hypertrophic scars stay within the boundary of the original wound. They often improve or flatten over time, especially with treatment.

Keloid scars grow beyond the edges of the original wound, invading surrounding healthy skin. They may continue to enlarge for months or even years if left untreated.

This distinction is vital because keloids generally require more aggressive and targeted treatments than hypertrophic scars.

Also Read: The 3 Types Of Acne Scars And How To Treat Them

Can keloid scars continue growing?

Yes—and this is one of the reasons keloids can be so frustrating. Unlike many other scar types, keloids don’t necessarily stop growing once the wound closes. Some may remain stable for years, while others slowly enlarge, thicken, or become more raised over time.

That’s why early intervention is key. The sooner we address a keloid, the better our chances of controlling it before it becomes more extensive.

Can keloids heal naturally with vitamin C, Vaseline, or Bio-Oil?

Sadly, keloids rarely resolve on their own. We often see patients diligently apply vitamin C serums, Vaseline, Bio-Oil, or other over-the-counter products for months with little to no effect.

While these products may support general skin health, they don’t actively shrink or flatten keloid tissue. At best, they help moisturise the surrounding skin and reduce irritation. In some early or mild cases, silicone gels or steroid creams may offer some improvement, but established keloids usually require medical intervention for meaningful results.

When should I see a doctor for keloids?

See a doctor if your keloid scar is:

Growing larger over time
Itchy or painful
Red, raised, or firm
Affecting your confidence or daily life

The earlier we start treatment, the better the outcomes tend to be.

What are the treatment options for keloid scars?

Here’s where we get to the good part: yes, there are many effective treatments for keloids—and often, combining treatments yields the best results.

Intralesional steroid injections (First-line treatment)

This is often where we begin. We inject corticosteroids (usually triamcinolone) directly into the keloid to reduce inflammation and suppress excessive collagen production. Over a series of sessions, this helps flatten the scar and soften its texture. Many patients see significant improvement after just a few treatments.

Typically, most patients require 3 to 6 steroid injection sessions spaced about 3 to 4 weeks apart for good flattening results. Some stubborn or larger keloids may need additional sessions.

The response can vary depending on the size and age of the keloid, the keloid’s location on the body, and how early treatment is started.

Maintenance may also involve silicone gel or sheets between visits to enhance and stabilise results.

Silicone gel sheets or silicone gel

Silicone creates a protective, hydrated barrier over the scar that helps regulate collagen production and prevents recurrence. We typically advise our patients to wear silicone sheets or apply gel daily for several months.

Steroid creams or steroid patches

Topical steroid formulations can supplement injections, especially for smaller or thinner keloids. They work best when applied consistently over 3 to 6 months.

Compression therapy

For specific areas, such as earlobe keloids, pressure earrings or compression dressings can help mechanically flatten the scar. The pressure needs to be applied consistently for the best effect.

For earlobe keloids (or other suitable areas), compression should ideally be worn for 6 to 12 months to achieve meaningful flattening and help prevent recurrence.

The key is daily, consistent wear—The more hours per day, the better (many protocols recommend 12–20 hours daily, depending on tolerance).

Want a doctor to walk you through? Book a consultation now.

Cryotherapy

Freezing the keloid with liquid nitrogen can help shrink smaller keloids, particularly those on the earlobes. It’s often combined with steroid injections for better results.

Cryotherapy is typically performed every 3 to 4 weeks, depending on the response and rate of healing. Many patients may need 3 to 6 sessions to see significant flattening, especially when combined with steroid injections. The interval allows skin to heal between freezes and reduces the risk of over-damaging healthy tissue.

5-Fluorouracil (5-FU) or Bleomycin injections

These medications may be injected into resistant keloids when steroids alone aren’t sufficient. They work by disrupting collagen synthesis at the cellular level.

5-Fluorouracil (5-FU) is a chemotherapy-derived medication that interferes with rapidly dividing fibroblast cells, the cells responsible for excess collagen in keloids. It’s often combined with steroids to help soften, flatten, and shrink thicker scars.

Bleomycin works by disrupting collagen production at the DNA level inside the scar tissue. It’s generally used for very thick, rigid, or highly resistant keloids. Bleomycin may cause minor side effects, such as changes in skin pigmentation, dryness, redness, and peeling at the injection site. Therefore, it’s usually reserved for more challenging cases.

Both options can be highly effective, particularly when combined with other treatments, such as corticosteroid injections or cryotherapy.

Vascular laser treatment

Lasers targeting blood vessels within the keloid help reduce redness, flatten the scar, and improve overall texture. Treatments are typically spaced every 3 to 6 weeks, with most patients requiring 4 to 8 sessions to achieve significant improvement. Vascular laser therapy is often used alongside steroid injections for comprehensive treatment and works exceptionally well for highly vascular or newer keloids.

Surgical excision

While tempting, surgical removal alone carries a high risk of recurrence—sometimes, the keloid returns even larger than before. However, surgery may still be an option when combined with post-surgical steroid injections, radiation, or silicone therapy to minimise recurrence.

Surgery works best for small, well-defined keloids, particularly earlobe keloids (very common after piercings) or flat-based keloids that are easy to excise fully

It is also an option if the keloid is highly resistant to non-surgical treatments, the keloid causes significant cosmetic or functional issues, or if patients prefer rapid size reduction.

Imiquimod cream

This immune-modulating cream may help reduce the recurrence of skin conditions after surgical removal by modifying the healing process. It’s typically used for smaller, well-defined keloids such as those on the earlobes or chest, especially after surgical excision.

Imiquimod is generally applied once daily (often at night) for 6 to 8 weeks after surgery to help reduce the risk of regrowth.

Summary of Keloid Treatments

Treatment	Best For
Steroid Injections	First-line for most keloids, especially early or moderately thick ones
Silicone Gel/Sheets	Maintenance, prevention, early mild keloids
Steroid Cream/Patch	Mild or thin keloids, adjunctive home care
Compression Therapy	Earlobe keloids, after excision
Cryotherapy	Small keloids (esp. earlobe), often combined with steroid injections
5-FU or Bleomycin Injections	Resistant, thick, mature keloids
Vascular Laser	Red, highly vascular, newer keloids
Surgical Excision (with adjunctive care)	Small, well-defined keloids (esp. earlobe), resistant cases
Imiquimod Cream	Post-surgical maintenance for smaller excised keloids

Can keloid scars be removed entirely?

With proper treatment, many keloids can be flattened or significantly improved. However, completely “curing” a keloid isn’t always possible.

Instead, the goal is long-term management: flattening the scar, softening its texture, relieving symptoms, and preventing regrowth.

Consistent follow-up and maintenance (such as continued use of silicone gel) help keep keloid recurrence at bay.

Schedule your consultation today!

Realistic expectations, real results

While keloids are one of the most stubborn scar types we treat, they’re not impossible to manage. The key is patience, consistency, and, often, a multi-pronged approach that combines injections, silicone therapy, and laser or other supportive treatments.

Early intervention truly makes a difference, so don’t wait for your scar to grow larger before seeking help. With proper care, we can achieve significant cosmetic improvement and restore comfort and confidence to your skin.

Ready to take control of your keloid?

If you’re frustrated with a keloid scar that’s not responding to home remedies, we’d be happy to assess your skin and create a personalised treatment plan. Every keloid is a little different, and together, we can find the best approach for you.

The Complete Guide to Keloid Scars – Treatment Options & Long-Term Management