Keloid Scarring Treatment

What is a keloid scar?

A raised and enlarged benign growth that grows outwards on the skin and is usually pink or darker than the surrounding skin and is caused by an overgrowth of skin cells. The reason why keloids occur is usually due to minor damage to the skin.

As you can see in the images above, ear piercings often cause keloid scarring. Keloid scars are not harmful; however, they can cause itchiness, tenderness, and discomfort to the ear, especially when sleeping or wearing certain items of clothing. The skin tissue can continue to grow larger over time, which is why many people choose surgical removal as they dislike the appearance.

Do you require keloid scarring treatment?

If you have any concerns about a keloid scar or if you are looking into surgical removal, speak to our skin specialists, Dr Wright & Mr Titus, here at The Lawrence Clinic.

Step-by-Step Approach to Treating Keloid Scars

Silicone Dressings and Pressure Therapy

• Silicone Gel Sheets or Creams: Silicone products are the first-line treatment, applied to hydrate the tissue, reduce collagen overproduction, and flatten the scar. Consistent daily use for several months yields the best results.
• Pressure Therapy: Pressure garments are used to compress the scar and promote scar remodelling, especially for high-risk areas like the chest or shoulders. Post-surgery, pressure therapy can also help prevent keloid recurrence.

Corticosteroid Injections

• Intralesional Steroids: Corticosteroids such as triamcinolone are injected directly into the keloid to reduce inflammation, suppress collagen synthesis, and flatten the scar. Multiple sessions spaced 4–6 weeks apart may be needed to achieve optimal results.
• Combination: Steroid injections can be used alongside silicone therapy or after surgery to enhance outcomes.

Triple Therapy

• Combination of Surgery, Steroids, and Radiation: For stubborn or recurrent keloids, triple therapy is often recommended. Surgery reduces the bulk of the keloid, followed by steroid injections and low-dose radiation to minimise recurrence.
• Post-Surgical Care: Silicone sheets and pressure therapy are essential during the healing phase to ensure the keloid does not regrow.

Surgical Treatment (Debulking Surgery)

• Debulking Rather Than Complete Excision: The primary goal of surgery is not complete excision, as this increases the risk of recurrence, but rather a reduction in the size and thickness of the keloid. Debulking preserves some of the scar tissue while alleviating symptoms like pain or itching and improving appearance.
• Adjunctive Measures: Following debulking surgery, corticosteroid injections, silicone therapy, or radiation are initiated immediately to suppress fibroblast activity and prevent the recurrence of excess tissue growth. The patient continues with pressure therapy and other non-invasive methods to maintain results.

Benefits and Long-Term Results

The stepwise treatment approach ensures tailored interventions for each patient. Early conservative therapies help manage smaller or less symptomatic keloids, while surgical debulking paired with adjunctive treatments provides a solution for larger or more advanced scars. This approach minimises recurrence and offers long-term improvements in both function and appearance. By combining treatments, the risk of regrowth is significantly reduced, resulting in smoother, less noticeable scars.

After your procedure:

• You will be given verbal advice on how to look after your wound, dressings, and bathing.
• If advised, your lesion will be sent to our histology lab and a report prepared.
• We advise that you do not drive following your procedure and be accompanied home.
• An appointment will be arranged for your post-operative follow-up and removal of sutures if required.

Conclusion

Keloid scar management requires a structured and multimodal approach. Surgical debulking, combined with adjunctive therapies, is highly effective for larger or recurrent keloids. By focusing on early interventions and comprehensive post-surgical care, patients can achieve lasting improvements in aesthetics and comfort, enhancing their overall quality of life.

To find out more about what we can treat and how to book, speak to our expert team using the details below:

• TikTok
• Facebook
• Instagram