Keloid management

A keloid is scar tissue that keeps growing beyond the edges of the original wound and does not settle on its own. It behaves differently to an ordinary raised scar: a hypertrophic scar stays within the boundary of the injury and improves over roughly a year, while a keloid extends past it — sometimes years after the original injury. Keloids are not cancerous and carry no risk of becoming cancerous, but they can be itchy, uncomfortable and genuinely distressing to live with, and they need active treatment rather than time.

Anaesthetic: Local, or general for larger lesions
Hospital stay: Usually a day case
Time off work: Varies with site
Final result: Managed over months, not weeks

A general guide only — your own timeline is confirmed at consultation.

What it involves

Treatment moves from least to most invasive. Early and small keloids often respond to conservative care — silicone tape or sheeting, and creams used to massage and flatten the scar. Once established, intralesional steroid injections are the mainstay, targeting the overactive scar-forming cells and helping to control the itch; the interval between injections is set by how long relief lasts for you. Where surgery is needed it is never performed on its own: excision is paired with a deliberate plan of steroid injections around the time of surgery, compression, and careful tissue handling, because the incision is itself a new wound in someone prone to keloids. Radiotherapy is reserved for resistant cases and carries its own long-term risk at the treated site.

Who it may suit

Worth assessing if a scar keeps growing beyond the original wound, has not settled after several months, or is increasingly itchy, painful or affecting your confidence. Keloid formation has a strong genetic component — family history matters, and black, Asian and Indian skin are more prone. Common sites include the earlobes after piercing, the beard and hairline, the chest, back and shoulders, and injection sites. The earlier a keloid is assessed, the smaller the eventual procedure tends to be.

Recovery

This varies considerably with the site and the treatment chosen. Steroid injections are quick and done in the rooms, usually repeated at intervals over several months. Where excision is performed, the wound heals over a couple of weeks — but the aftercare protocol of injections, compression and close follow-up continues well beyond that, and it is the part that determines whether the keloid returns. Keloid management is best thought of as an ongoing plan rather than a single procedure.

This page is a general guide. Every procedure is planned individually — the details, risks and recovery relevant to you are discussed at consultation.

Common questions

Can a keloid just be cut out?

Not on its own. The incision is a new wound, and in someone prone to keloids that wound can produce another keloid — often larger than the first. Repeated excision without a planned aftercare protocol reliably makes the problem worse, which is why the plan around the surgery matters as much as the surgery.

Will it come back?

There is no treatment that removes the underlying genetic tendency, so the aim is to manage the keloid effectively and reduce the chance of recurrence rather than to promise it will never return. Honest expectations here are part of the treatment.