Surgical and adjuvant management of keloid and hypertrophic scars.
A keloid is a scar that grows beyond the boundary of the original wound and does not settle on its own. Treatment combines injections, surgery and adjuvant therapy. Surgery alone has a high recurrence rate, so it is almost never used by itself.
The distinction matters because treatment differs. A hypertrophic scar is raised but stays within the boundary of the original wound, and it usually improves on its own over a year or two.
A keloid grows outward beyond the original injury, into skin that was never damaged. It does not regress spontaneously. Keloids are more common on the chest, shoulders, upper back and earlobes, and there is often a family tendency. Someone who has formed one is likely to form another.
The intuitive treatment is to remove it. Done alone, that fails in a majority of cases, often returning larger than before, because the excision creates a fresh wound in skin already prone to keloid formation.
Effective treatment therefore combines approaches. Steroid injections flatten and soften, often as first line. Where surgery is used, it is followed immediately by adjuvant treatment such as injections, pressure therapy for earlobes, silicone, or in selected cases low dose radiotherapy. That combination brings recurrence down substantially, though never to zero.
Keloid treatment manages a tendency rather than curing it. The aim is a flatter, softer, less itchy and less noticeable scar, not the absence of a scar.
Treatment usually runs over months, with injections repeated at intervals of four to six weeks. Patients who expect one procedure and a clear result are the ones who become frustrated, so setting the timeline honestly at the start matters more here than in almost any other treatment.
| Factor | What it covers |
|---|---|
| Size and site | Earlobe keloids differ greatly from extensive chest keloids |
| Injection course | Repeated sessions at four to six week intervals |
| Surgery | Excision where indicated, priced by size and site |
| Adjuvant therapy | Pressure devices, silicone, or radiotherapy in selected cases |
| Duration | Treatment usually continues over several months |
These pages answer the questions that most often come up alongside this one.
Because treatment is usually a course rather than a single procedure, cost accumulates over months. Injection sessions are priced individually, and surgery with adjuvant therapy is estimated separately. A plan with expected total cost is given at consultation.
There is always a risk, and any clinic promising otherwise is not being straight with you. Surgery alone recurs in most cases. Combined treatment reduces recurrence substantially, and ongoing follow up allows early treatment if it starts to return.
They sting, and injecting into dense keloid tissue is uncomfortable for a few moments. Cooling and local anaesthetic help. The discomfort is brief and settles quickly.
Typically several, spaced four to six weeks apart, over a course of months. The number depends on size, site and how the keloid responds, and is reviewed as you go.
It can be excised, but excision alone frequently leads to a larger recurrence. Removal is only sensible as part of a combined plan with adjuvant treatment immediately afterwards.
Generally yes. Earlobe keloids, often after piercing, respond well to excision followed by pressure therapy with clips or magnets, plus injections. They remain one of the more satisfying keloids to treat.
Recurrence is the main one. Steroid injections can thin the skin, lighten the colour and cause visible small vessels at the site. Surgery carries the usual risks of bleeding and infection, plus the risk of a larger scar if recurrence occurs.
Usually not, as it is often classified as cosmetic. Where a keloid causes documented functional problems, pain or recurrent infection, some policies may consider it, and cover is confirmed before treatment.
Published with written patient consent and shown for education rather than promotion. Every case is different and these images are not a promise of results.
Consultations at Kiran Hospital, Katargam, Surat. Outstation and NRI patients can request a video consultation before travelling.