Keloid scar treatment (Treatment of keloid (and hypertrophic) scars)

What is keloid scar treatment?

A keloid is a scar that overgrows beyond the original wound, becoming raised, firm and sometimes itchy or painful. Unlike a hypertrophic scar, which stays within the wound and often settles with time, a keloid spreads into surrounding skin and tends to persist. They are more common in people with darker skin and after injuries to the chest, shoulders, earlobes and jawline.

Keloid scar treatment is not a single operation but a range of approaches used alone or together: steroid injections, silicone gels or sheets, pressure (for example earlobe pressure earrings), freezing (cryotherapy), laser, and, in selected cases, surgery usually combined with another treatment to stop regrowth.

The aim is to flatten and soften the scar and ease symptoms, not to make it disappear completely. Keloids are notoriously prone to coming back, especially after surgery used on its own, so realistic expectations and a long-term plan matter.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Hypertrophic scar vs keloid

Telling the two apart matters, because it changes how likely treatment is to work and how aggressively recurrence must be guarded against.

Preparing for your treatment

• Ask whether your scar is a keloid or a hypertrophic scar, as this changes the outlook and plan.
• Discuss a realistic goal: flattening, softening and easing symptoms rather than complete removal.
• Understand that several sessions over months are usually needed and that keloids can recur.
• Tell your clinician about your skin tone and any previous keloids, as these affect risk and treatment choice.
• Mention pregnancy, medicines and any skin conditions before steroid injections, cryotherapy or laser.
• If surgery is suggested, ask exactly what will be done afterwards to stop the keloid coming back.
• Protect the scar from the sun, which can worsen discolouration.

What happens

What happens depends on the treatment. A steroid injection is done in clinic and takes a few minutes: the scar is injected directly, which can sting, and the session is usually repeated every few weeks over several months.

Silicone and pressure treatments are applied at home over months, following instructions on how long to wear them each day. Cryotherapy and laser are short clinic treatments, sometimes combined with injections.

Surgery to remove a keloid is planned separately. The scar is cut out, usually under local anaesthetic, and a plan is put in place straight away to prevent regrowth, such as steroid injections, pressure or, in some centres, radiotherapy within a day or two. You will be told what to expect for your specific treatment.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Comfort, sedation or contrast choices

If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.

The biggest issue with keloids is recurrence: they commonly come back, and surgery on its own often makes them regrow larger, which is why surgery is normally combined with another treatment. Steroid injections can thin or discolour the skin, and treatments can lighten or darken darker skin tones. Ask your clinician how they will guard against recurrence and what the realistic outcome is for your skin and scar.

Published figures to discuss

Keloids are defined partly by their tendency to recur, but exact recurrence figures vary a great deal depending on the treatment, the scar and how long people are followed, and many published figures come from selected hospital series. The points below are cautious, source-defensible patterns rather than precise predictions for any one person.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

Most keloid treatments need little or no recovery, but the scar changes slowly. Improvement happens gradually over months and several sessions, and the plan often continues long after the first treatment to keep the keloid from coming back.

• Mild soreness at the injection site for a day or two
• Slow, gradual flattening rather than an overnight change
• Itching and tenderness easing before the scar fully settles
• Needing to keep up silicone, pressure or follow-up over months

Aftercare

• Follow the schedule for repeat injections or daily silicone and pressure, as consistency matters.
• Protect the scar from the sun to limit discolouration.
• Keep any surgical wound clean and dry, and start the planned anti-recurrence treatment as directed.
• Watch for early signs of the scar thickening again and report them.
• Avoid picking, scratching or further skin trauma at the site.
• Attend follow-up so the response can be checked and the plan adjusted.
• Tell your clinician if you notice skin thinning, colour change or new symptoms.

• Clear schedule for repeat sessions noted
• Silicone gel or sheets, or pressure device, ready if advised
• Sun protection for the scar
• A way to keep any surgical wound clean and dry
• Knowledge of what add-on treatment follows surgery, and when
• Follow-up appointments booked
• Clinic contact number saved for any problems

Scars and how they heal

Keloid treatment is itself about scars, so the focus is on how the scar changes. With successful treatment a keloid becomes flatter, softer and less symptomatic, though some mark usually remains. The skin over a treated keloid may end up lighter, darker or slightly thinned, particularly after repeated steroid injections or cryotherapy, and more so in darker skin tones. After surgery there is a new wound that must be managed carefully to avoid another keloid.

⚠ Get urgent help if…

• The scar becoming rapidly larger, firmer or more raised again
• Spreading redness, heat, swelling or discharge (signs of infection)
• A surgical wound that opens up or will not heal
• Increasing pain rather than the usual easing
• Marked thinning, denting or colour change of the skin at the treated site
• Any new lump or change you are unsure about

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result is a flatter, softer, less itchy or painful scar that bothers you less, achieved gradually over months. Treatment can markedly improve comfort and appearance, but it rarely removes a keloid completely, and the scar usually remains visible to some degree.

Because keloids tend to recur, a good outcome also means the scar staying settled over time, which is why follow-up and a long-term plan are part of treatment. Your clinician should be clear that the goal is improvement and control, not a guaranteed cure.

Keloids are a long-term tendency rather than a one-off problem. Even after successful treatment, they can come back months or years later, particularly after surgery used alone, so ongoing measures such as silicone, pressure or occasional top-up injections may be needed. People prone to keloids should be cautious about future elective skin injury, including piercings and tattoos.

Related tests, treatments or support

Keloid treatments are frequently combined, because no single approach works for everyone and combining them improves results and reduces recurrence. Common combinations include steroid injection with silicone and pressure, cryotherapy with injection, and surgery followed promptly by injections, pressure or, in selected cases, radiotherapy. Your clinician will tailor the combination to your scar and skin.

Follow-up & long-term care

You will usually be reviewed every few weeks during a course of injections, and then periodically to check the scar stays settled. If the keloid starts to thicken again, treatment can be restarted or adjusted. After surgery, prompt and sustained follow-up is especially important because the risk of regrowth is highest then. Report any early signs of recurrence rather than waiting.

• Continue silicone gel or sheets and any pressure treatment for as long as advised.
• Keep protecting the scar from the sun to limit discolouration.
• Return for top-up steroid injections if the scar begins to thicken again.
• Avoid unnecessary skin trauma, piercings or tattoos at keloid-prone sites.
• Report early signs of recurrence promptly so treatment can resume.

Repeat, follow-on and what comes next

• Keloids often need repeated or ongoing treatment, and a single session rarely settles them for good.
• If a keloid recurs, treatment can be restarted or escalated, for example adding pressure or considering radiotherapy after surgery.
• Surgery is usually reserved for selected keloids and always paired with measures to prevent regrowth.
• Some discolouration or a residual scar usually remains even after successful treatment.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• A clear, written long-term plan, including repeat injections, silicone or pressure as needed.
• Prompt anti-recurrence treatment after any surgery, with close monitoring.
• A named contact route and advice on early signs of recurrence and skin side effects.
• Honest discussion that the aim is to control and improve the scar, not cure the tendency to keloid.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• The treatment or combination chosen, from injections to surgery with add-on treatment
• The number of sessions, as a course of injections is usual
• The clinician's fee and whether a dermatologist or plastic surgeon is involved
• The size, site and number of scars
• Whether silicone, pressure devices or laser are included
• If surgery is used, the theatre or facility fee and the cost of radiotherapy where applicable
• Follow-up appointments over the months of treatment

• The clinician's fee and the expected number of sessions
• What each session and any follow-up includes
• Devices or products such as silicone or pressure earrings
• If surgery is planned, the facility fee and the cost and provider of any radiotherapy
• What happens, and what it costs, if the keloid recurs
• The cancellation policy
• What is included if a complication needs treating

On the NHS? Some keloid treatments are available on the NHS, often where the scar causes symptoms such as pain or itching, but access and the options offered vary by area, and treatment regarded as cosmetic may not be funded.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• Is my scar a keloid or a hypertrophic scar, and how does that change the plan?
• What realistic improvement can I expect, and how many sessions might I need?
• If surgery is suggested, exactly what will be done to stop it growing back?
• How will you protect my skin tone from lightening or darkening?
• What are the chances this keloid comes back, and what is the long-term plan?
• What signs of recurrence should I watch for, and when should I come back?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my treatment, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this treatment not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for keloid scar treatment

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Keloid scars British Association of Dermatologists — patient information Triamcinolone (steroid) injection for keloid scars — review (PMC) Royal Free London NHS — Keloid and hypertrophic scars guide BAPRAS — Information about plastic surgery

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.