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Keloids are a type of raised scar that form due to an overproduction of collagen during the healing process. In simple terms, they are scars that grow beyond the original wound boundary, creating smooth, firm bumps that can be larger than the initial injury. Keloids can develop anywhere on the body (common areas include the chest, shoulders, earlobes, and cheeks) and may be pink, red, or darker than your surrounding skin. They’re benign – meaning they aren’t harmful or cancerous – but they can be itchy, tender, or even painful at times. Many people with keloids also feel self-conscious about their appearance, which is why finding the right treatment is so important.
What Causes Keloids?
Keloids form because of an overactive healing process. When your skin is injured, your body tries to repair it by producing collagen (the protein that helps form scar tissue). In some people, the body produces too much collagen, leading to a scar that keeps growing even after the wound is healed . Essentially, the scar doesn’t get the signal to stop, resulting in a keloid.
Often, keloids appear a few months (or even years) after the skin trauma. There are also personal risk factors that make keloids more likely for some people. For example, keloids tend to be more common in individuals with deeper skin tones (though they can occur in any skin type). They also frequently develop in younger people (late teens to mid-20s) and can run in families, suggesting a genetic predisposition.
Myth busting: One common myth is that keloids are caused by infection or “bad” aftercare. In reality, even with perfect wound care, a keloid can still form if your skin is prone to this type of scarring. It’s not your fault, it’s just how some people’s bodies heal. Keloids also aren’t contagious, and you didn’t “catch” it from anyone. The tendency to form keloids lies in your skin’s healing response.
What Is the Difference Between Keloids and Hypertrophic Scars?
It’s easy to confuse keloids with hypertrophic scars, since both can be raised and firm. The key difference is in how much the scar grows. Hypertrophic scars stay within the boundary of the original wound, whereas keloids grow beyond it.
Another difference is the natural course of these scars. Hypertrophic scars often improve on their own over time and they might gradually flatten and fade after months or years. Keloids, on the other hand, tend to persist or even continue growing if left untreated. A hypertrophic scar might soften and become less noticeable eventually, but a keloid is more likely to stick around. Keloids are also usually more difficult to treat and have a higher chance of coming back after treatment.
From a symptom perspective, both types of scars can be itchy or uncomfortable, but keloids are more notorious for causing prolonged itching or tenderness. Visually, keloids often become larger and can take on a smooth, shiny appearance on the skin, whereas hypertrophic scars stay closer to the size of the original wound and may have a firmer, ridged appearance.
Do Keloids Go Away on Their Own?
Keloids typically do not go away by themselves. This is a crucial point and a common misconception. Unlike ordinary scars (or even hypertrophic scars) that might slowly fade and flatten over time, keloids are quite persistent. In fact, many keloids remain the same or even enlarge over time if you don’t treat them.
It’s very rare for a keloid to completely disappear without intervention. Sometimes, a small keloid might become slightly flatter or softer years down the line, but complete spontaneous healing is uncommon. This means if you’re hoping a keloid will simply shrink away on its own, you’ll likely be disappointed. In most cases, some form of treatment is needed to significantly reduce a keloid.
Myth busting: A related myth is that you can use home remedies to “dissolve” a keloid over time. While some home treatments (like certain oils or lotions) might keep the scar moisturized or help with itchiness, they usually won’t make a true keloid go away. Keloids involve deep scar tissue, and surface-level treatments have minimal impact on their size. Keeping the skin moisturized and protected is never a bad idea, but be cautious of over-the-counter scar creams that promise to erase keloids, if it sounds too good to be true, it probably is.
How Are Keloids Treated?
The good news is that there are several treatment options to help flatten or reduce keloids. The right choice for you can depend on the keloid’s size, location, and your medical history. Often, doctors may use a combination of treatments for the best result, since keloids can be stubborn. Here are some of the current treatment approaches for keloid scars:
- Corticosteroid Injections (Cortisone Shots): This is one of the most common treatments. A doctor injects a steroid medication directly into the keloid to help shrink it. These injections reduce inflammation and tell the scar tissue to slow down collagen production. Typically, injections are given on a schedule (for example, every few weeks) over a few months to gradually flatten the scar. Many patients notice their keloid becoming softer and flatter after a series of shots. (Side note: a possible downside is that steroid injections can sometimes lighten the skin color or cause thinning of the skin at the site, but for most people the benefit of a smaller keloid outweighs these minor effects.)
- Laser Therapy: Lasers (such as pulsed-dye laser treatments) can help flatten keloids and reduce redness. Laser therapy is usually done in multiple sessions spaced a few weeks apart. This treatment is good for smoothing out the texture of a keloid and making it less noticeable. Sometimes laser is combined with steroid injections for a one-two punch: the laser reduces the bulk of the scar and the injection calms the scar-forming activity. Patients with darker skin should use lasers with caution, as lasers can affect pigmentation; a qualified physician will use the appropriate settings to minimize any changes in skin color.
- Excision (Surgical Removal) with Combined Therapy: In some cases, the keloid can be surgically cut out (excised) by a physician . This immediately removes the bulk of the scar. However, and this is very important, surgery alone has a high chance of the keloid coming back. Keloids have a tendency to recur (in fact, surgery by itself can trigger the body to form another keloid in that area). To improve the outcome, doctors almost always pair excision with other treatments. Corticosteroid injections are usually given during or after the removal procedure to help prevent the new scar from overgrowing. Other methods like applying pressure dressings or even short-term radiation therapy to the area after excision have been used in difficult cases to reduce recurrence . The combined approach of removal and additional therapy, significantly lowers the chance that the keloid will return as large as before (though it’s not a 100% guarantee). Surgical removal is typically reserved for keloids that are large or not responding to less invasive treatments, and it should be done by an experienced physician familiar with keloid management.
- Silicone Gel or Patches: Silicone sheets or gels (available over the counter) are a gentle treatment often used on new scars or after keloid treatment. Wearing a silicone sheet over a healing area can help keep it flat and hydrated. On an existing keloid, silicone gel might soften the scar over time, though silicone alone usually won’t dramatically shrink a well-established keloid. Still, it can be part of a maintenance routine and is sometimes recommended after other treatments to support the results.
- Pressure Therapy: Applying pressure to a keloid-prone area can discourage a scar from growing. For example, after removing a keloid on the earlobe, doctors may recommend wearing a special pressure earring or compressive dressing for a few months. The constant pressure flattens the area and makes it harder for excess scar tissue to form. Pressure therapy can be uncomfortable (imagine wearing a tight bandage for 12+ hours a day), but for areas like the ears, it’s a proven preventive step. This method is often used alongside other treatments; by itself, pressure might not shrink an existing keloid much, but it can help after a surgical removal or injection therapy.
It’s important to have a realistic expectation: treatment can significantly improve a keloid (make it flatter, smaller, and less symptomatic), but keloids sometimes don’t disappear completely. Also, keloids can recur (come back). For instance, you might get a keloid to flatten out with injections, but over a couple of years it could slowly thicken again – in which case you might need another round of treatment.
Schedule a Consultation
Living with keloids can be frustrating, but you don’t have to navigate it alone. If you have a keloid that’s bothering you. Whether it’s painful or simply something you’re self-conscious about, consider scheduling a consultation with one of our experienced physicians. A one-on-one evaluation will give you personalized insight into which treatment approach is best for you.
Remember, keloids are a medical condition, and seeking professional care is not about vanity; it’s about your comfort and confidence. During a consultation, the physician can examine your scar, discuss your treatment history (if any), and outline a plan to help reduce the keloid safely. They’ll also answer any
questions you have, so you can make an informed decision.
Schedule your consultation today. We’re here to guide you toward smoother, healthier skin.