Skin Health More Skin Conditions Prevention and Treatment for Keloids By Susan J. Huang, MD Susan J. Huang, MD Facebook Twitter Susan Huang, MD, FAAD, is a board-certified dermatologist practicing at Sutter Health. She is also an instructor at Harvard Medical School. Learn about our editorial process Updated on September 17, 2020 Medically reviewed by William Truswell, MD Medically reviewed by William Truswell, MD Facebook LinkedIn William Truswell, MD, is a board-certified facial plastic surgeon and otolaryngology (head and neck) surgeon. He is president of the American Board of Facial Plastic and Reconstructive Surgery and treats skin cancer patients as part of his practice. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Keloid Prevention Keloid Treatments A keloid is an abnormal scar that may also be itchy, painful, and spreads beyond the original borders of the skin injury. There are many ways to treat keloids, but if you know you are likely to form keloids, the most effective strategy is to prevent keloid formation in the first place. This photo contains content that some people may find graphic or disturbing. See Photo Keloid scar on hand. How to Prevent Keloid Formation You can prevent keloid formation by avoiding skin injuries like: Cuts Surgery Body piercing Infection Acne If you form keloids in response to acne, it is important to treat the acne quickly and use medications to help prevent its return. If you have acne, avoid shaving your neck and face, as doing so may irritate your acne and stimulate more keloid formation. Instead, use scissors to trim your facial hair. Keep the hairs at least one-eighth of an inch long. Additionally, proper treatment of wounds may help minimize scar formation and, in turn, reduce keloid formation. Try to keep your wounds moist with petroleum jelly and covered with a non-stick bandage. Keep your scar hidden from the sun for at least the first three months after an injury to avoid excessive darkening of the scar. Keloid Treatments There are numerous treatments available for keloids: Intralesional (injected) corticosteroids Excision Silicone gel sheeting Cryosurgery Pressure earrings Radiation therapy Interferon alpha Laser therapy Injection of fluorouracil A dermatologist, a facial plastic surgeon, or a plastic surgeon can recommend one or a combination of these treatments. It is important to note that keloids may return after treatment. Get your keloids treated as early as possible, since this increases the chance they will respond to treatment. Intralesional Corticosteroids Intralesional (injected) corticosteroids are usually the first type of therapy recommended for the treatment of keloids. A needle is used to inject a steroid, typically triamcinolone, directly into the keloid. Liquid nitrogen may be applied prior to injection. Injections are repeated every month until the keloid becomes flatter and softer. One study showed an 82.7% reduction in the size of the scar three months after the last injection. The treatment may be combined with other therapies for better results. Surgical Excision In a surgical excision, a scalpel (a sharp surgical blade) is used to remove the keloid. Triamcinolone or another medication called interferon is often injected before, during, or after the excision. Injecting triamcinolone around the time of surgery helps prevent the keloid from returning. Silicone Gel Sheeting Silicone gel sheets are sticky clear sheets placed over scars. They allow oxygen to pass through and help maintain a moist environment to improve healing. They may help reduce pain or itching from keloids and prevent the growth of new or existing keloids. For optimal effectiveness, silicone gel sheets should be used for at least three months and at least four hours a day. They are available either by prescription or over-the-counter and should be cut to the size of keloid and taped into place. The sheet should be washed daily and replaced according to the manufacturer’s instructions. Cryosurgery This refers to the use of liquid nitrogen sprayed onto your keloid for two 15-second sessions. This therapy can be repeated up to six times and is often combined with other treatments. It is important to note that in patients with darker skin, the skin treated with liquid nitrogen may become lighter or darker. Pressure Earrings These are inexpensive earrings customized to you which compress your earlobe. They are worn over your earlobe immediately after piercing to prevent a keloid from forming. Radiation Therapy An external X-ray beam is applied to a keloid. Radiation therapy can prevent a keloid from re-growing after it was surgically removed in a majority of patients. Although any exposure to radiation increases the risk of cancer, the amount used in treating keloids is generally considered very safe. Interferon-Alpha Interferon-alpha are proteins released by cells to help activate the immune system. They may be injected after a keloid is surgically removed in order to prevent recurrence. Although it is an expensive therapy, research suggests it may have promising effects, particularly on scars resistant to other forms of treatment. Intralesional Fluorouracil This is a chemotherapeutic drug injected into keloids. It treats keloids by blocking DNA replication. This stops fibroblasts, the cells that overgrow in a keloid, from reproducing. Some patients report ulceration and pain as side effects. This treatment may also be combined with intralesional corticosteroid injections. Pulsed Dye Laser A pulsed dye laser is a laser that has been shown to improve keloids and is especially helpful for reddish keloids and scars. Other lasers such as fractional lasers have also been used to treat keloids. Laser treatment can be performed in combination with intralesional injection of either corticosteroids or fluorouracil. 12 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Harvard Medical School Harvard Health Publishing. Keloids. NHS. Keloid scars. University of Michigan Medicine. Keloid scars. Medical University of South Carolina. Scar revision and keloid treatment. Morelli Coppola M, Salzillo R, Segreto F, Persichetti P. Triamcinolone acetonide intralesional injection for the treatment of keloid scars: patient selection and perspectives. Clin Cosmet Investig Dermatol. 2018;11:387-396. doi:10.2147/CCID.S133672 Westra I, Pham H, Niessen FB. Topical silicone sheet application in the treatment of hypertrophic scars and keloids. J Clin Aesth Dermatol. 2016;9(10):28-35. Barara M, Chander R, Mendiratta V. Cryotherapy in treatment of keloids: evaluation of factors affecting treatment outcome. J Cutan Aesthet Surg. 2012;5(3):185-189. doi:10.4103/0974-2077.101376 Rathee M, Kundu R, Tamrakar A. Custom made pressure appliance for presurgical sustained compression of auricular keloid. Ann Med Health Sci Res. 2014;4(Suppl 2):S147-S151. doi:10.4103/2141-9248.138040 Xu J, Yang E, Yu N, Long X. Radiation therapy in keloids treatment. Chinese Medical Journal. 2017;130(14):1715-1721. doi:10.4103/0366-6999.209896 Gauglitz G. Management of keloids and hypertrophic scars: current and emerging options. Clin Cosmet Investig Dermatol. 2013;6:103–114. doi:10.2147/CCID.S35252 Shah VV, Aldahan AS, Mlacker S, Alsaidan M, Samarkandy S, Nouri K. 5-fluorouracil in the treatment of keloids and hypertrophic scars: a comprehensive review of the literature. Dermatol Ther (Heidelb). 2016;6(2):169-183. doi:10.1007/s13555-016-0118-5 Stephanides S, Rai S, August PJ, Ferguson JE, Madan V. Treatment of refractory keloids with pulsed dye laser alone and with rotational pulsed dye laser and intralesional corticosteroids. Laser Therapy. 2011;20(4):279-286. doi:10.5978/islsm.12-OR-01 Additional Reading Arno AI, Gauglitz GG, Barret JP, Jeschke MG. Up-to-date approach to manage keloids and hypertrophic scars: a useful guide. Burns. 2014;40(7):1255-1266. doi:10.1016/j.burns.2014.02.011 Kaiser Permanente. Keloid scars. NYU Langone Health. Recovery & support for scars & keloids. van Leeuwen MCE, Bulstra AEJ, Ket JCF, Ritt MJPF, van Leeuwen PAM, Niessen FB. Intralesional cryotherapy for the treatment of keloid scars. Plastic and Reconstructive Surgery - Global Open. 2015;3(6):e437-. doi:10.1097/GOX.0000000000000348 Weshahy AH, Abdel Hay R. Intralesional cryosurgery and intralesional steroid injection: a good combination therapy for treatment of keloids and hypertrophic scars. Dermatol Ther. 2012;25(3):273-276. doi:10.1111/j.1529-8019.2012.01456.x Wilson, AM. Eradication of keloids: surgical excision followed by a single injection of intralesional 5-fluorouracil and botulinum toxin. Canadian Journal of Plastic Surgery. 2013;21(2):87-91. doi:10.1177/229255031302100208 By Susan J. Huang, MD Susan Huang, MD, FAAD, is a board-certified dermatologist practicing at Sutter Health. She is also an instructor at Harvard Medical School. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit