Keloid scar treatment is possible. If you don't like how a keloid looks or feels, talk with a doctor about how to flatten or remove it. Even with treatment, a keloid can last for years or recur.
1. Methods of treatment of keloids
Keloid scar treatments include the following. One or a combination of approaches might be best for your situation. Even after successful flattening or removal, keloids can grow back, sometimes bigger than before. Or you may develop new ones.
- Wound care. For newer keloids, the first treatment option might be compression dressings made from stretchy fabric or other materials. This method is also used after surgery to remove keloids. The goal is to reduce or prevent a scar by putting pressure on the wound as it heals. Such dressings need to be worn for 12 to 24 hours a day for 4 to 6 months to be effective. This method can be very uncomfortable.
- Corticosteroid cream. Applying a prescription strength corticosteroid cream can help ease itchiness.
Injected medicine. If you have a smaller keloid, your doctor might try reducing its thickness by injecting it with cortisone or other steroids. You'll likely need monthly injections for up to six months before seeing the scar flatten. Possible side effects of corticosteroid injections are skin thinning, spider veins and a permanent change in skin color (hypopigmentation or hyperpigmentation).
- Freezing the scar. Small keloids might be reduced or removed by freezing them with liquid nitrogen (cryotherapy). Repeat treatments might be needed. Possible side effects of cryotherapy are blistering, pain and loss of skin color (hypopigmentation).
- Laser treatment. Larger keloids can be flattened by pulsed-dye laser sessions. This method has also been useful in easing itchiness and causing keloids to fade. Pulsed-dye laser therapy is delivered over several sessions with 4 to 8 weeks between sessions. Your doctor might recommend combining laser therapy with cortisone injections. Possible side effects, which are more common in people with darker skin, include hypopigmentation or hyperpigmentation, blistering and crusting.
- Radiation therapy. Low-level X-ray radiation alone or after surgical removal of a keloid can help shrink or minimize the scar tissue. Repeat treatments might be needed. Possible side effects of radiation therapy are skin complications and, in the long term, cancer.
Surgical removal. If your keloid hasn't responded to other therapies, your doctor might recommend removing it with surgery in combination with other methods. Surgery alone has a recurrence rate of 45% to 100%.
2. Alternative medicine
There are no proven methods of removing keloid scars naturally. Some clinical studies have shown that onion extract used orally or on the skin might possibly be effective in improving the appearance of keloid scars and reducing itchiness and discomfort.
Potential future treatments
Research into wound-healing issues, including keloid formation, shows promise. For example, studies include:
- Experimental topical creams and injectables to reduce and stop the growth of keloids
- Botulinum toxin type A (Botox) to improve wound healing
- Identifying genetic markers in keloid tissue
- Stem cell therapy
3. Lifestyle and home remedies
Try these keloid self-care tips:
- Care for your wound as directed. Wound care can be time-consuming, and compression dressings can be uncomfortable. Try to stick with the routine recommended by your doctor, as these steps are important to keloid prevention.
- Apply a corticosteroid cream. This type of nonprescription cream can help ease itchiness.
- Apply silicone gel. Applying nonprescription silicone gel can help ease itchiness.
- Protect the area from re-injury. Avoid irritating the keloid with clothing or other types of friction or injury.
- Protect your skin from the sun. Sun exposure might change the color of your keloid, making it more noticeable. That change might be permanent. Before going outside, protect your skin by covering the keloid or by liberally applying sunscreen.