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What is the Best Keloid Scar Treatment?
Keloid scars can be challenging to treat because they are different from ordinary scars. A keloid is an overgrowth of scar tissue that extends beyond the original wound. Unlike many scars, keloids generally do not flatten or disappear on their own. There isn't one treatment that is considered the "best" for every keloid. The most appropriate treatment depends on the size, location, age of the keloid, and whether you have had previous treatments. Corticosteroid injections are one of the most commonly used treatments for keloids. The medication is injected directly into the scar and can help flatten and soften it while reducing itching, tenderness, and discomfort. A series of treatments is often necessary. The American Academy of Dermatology reports that 50%–80% of keloids shrink after corticosteroid injections, although some can eventually grow back. Surgical removal can be an option for some larger or troublesome keloids, but removing a keloid alone is generally not enough. Keloids have a significant tendency to come back after surgery, so additional treatment—such as corticosteroid injections, pressure therapy, cryotherapy, or, in selected cases, radiation—may be recommended to reduce the chance of recurrence. If you are prone to keloids, it is also important to tell your surgeon before having any elective procedure. Even a relatively small injury, piercing, or surgical incision can potentially cause another keloid. Early treatment when a scar first begins to thicken may help prevent it from becoming larger.
Clinical Context
There's no single best treatment for keloids because success depends on combining approaches over months, not weeks. Early intervention with steroid injections, silicone sheeting, or pressure therapy often starts showing softening and flattening within four to eight weeks, but full results typically take several months of repeated visits. Laser treatments and surgical excision, when used, are usually paired with injections afterward to lower recurrence risk. Because keloids can regrow even after they seem resolved, expect ongoing monitoring for a year or longer, with prompt follow-up if thickening, itching, or spreading returns.
