Condition

Keloids

A keloid is a scar that keeps growing after the wound has already healed, spreading past the edge of the original injury. Keloids are not cancer, but they can itch, hurt and keep enlarging, and they are far more common on deeper skin tones.
Dr. Schwarz, MD · Board-certified dermatologistLast reviewed September 8, 2026
16:9 hero for Keloids. Never cropped: the tone strip and the corner logo depend on the full frame.

Start here

A keloid is not a thick scar. It is scar tissue that never got the signal to stop, so it grows past the edges of the wound and rarely settles on its own. Treatment is about control rather than removal, usually a course of injections over months, because cutting a keloid out on its own often produces a bigger one. If you have had one, tell every clinician before any procedure, including piercings and mole removals, because it changes how I would close a wound and whether I would do the procedure at all.

— Dr. Schwarz, Board Certified Dermatologist

Key Facts

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How commonCommon, and much more common on deeper skin tones. Published estimates for people of African descent range from roughly 5 to 15 percent
Who gets itMost often people between about 10 and 30, people with a family history, and people with deeper skin tones. Rare in very young children and older adults
Curable or managedManaged. Keloids can be flattened, softened and made much less symptomatic, but they rarely disappear and they come back readily
Prescription neededUsually. Silicone and pressure are available over the counter. Steroid injections and the other effective treatments are done in a clinic
Time to improveMonths. Injections are usually repeated every four to six weeks, and a course commonly runs six months or longer

What It Is

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A keloid is an overgrowth of scar tissue. When skin is injured deeply enough to reach the dermis, the layer beneath the surface, the body lays down collagen to repair it. In a keloid that repair never switches off. Collagen keeps coming, and the scar grows past the borders of the original wound into skin that was never injured.

That is the defining feature. A hypertrophic scar is also raised and thick, but it stays inside the wound outline and usually flattens over one to two years. A keloid crosses the border and keeps going, which changes what treatment can achieve.

Keloids are firm, rubbery and raised, and can be pink, red, purple, brown or darker than the skin around them. Older ones turn paler and harder. Most are itchy, tender or painful, and they feel tight over a joint or on the chest. Those symptoms, not the appearance, bring most people in.

They start after almost any injury that breaks the deeper skin: piercings, surgery, cuts, burns, vaccinations, insect bites, acne, ingrown hairs, folliculitis. Some appear with no injury anyone remembers, usually on the chest. Common sites are the earlobes, jawline, front of the chest, shoulders, upper back and back of the neck.

Keloids are not cancer and do not become cancer. They are not contagious and not caused by poor wound care, though infection and slow healing make them more likely. Who gets them is mostly genetic.

Symptoms

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A ball on the lobe

Earlobe or Piercing

A firm, round lump growing from a piercing site, most often on the earlobe, months after the piercing healed. It keeps growing beyond the original wound. These are common and treatment is usually a combination approach.
Raised bands over old spots

Chest, Shoulder or Jaw

Thick, raised, sometimes itchy or tender scars on the chest, shoulders or jawline, often starting from acne rather than injury. They are more common in deeper skin tones. Preventing new spots in those areas matters.
A scar that outgrows the cut

Along a Surgical Scar

A scar that thickens and spreads sideways past the edges of the original wound, rather than staying within it. This is what separates a keloid from a normal raised scar. Anyone with a history of one should mention it before planned surgery.

How It Looks by Skin Tone

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A raised, smooth, firm scar on the upper chest on light skin. It is shiny pink-red and hairless, and its edges spread well past the small mark it grew from.A raised, smooth, firm scar on the upper chest on medium tan skin. It is dusky pink-brown and only slightly different in color from the skin around it, and its edges spread well past the small mark it grew from.A raised, smooth, firm scar on the upper chest on brown skin. It is brown-purple rather than red, shiny and hairless, and its edges spread well past the small mark it grew from.A raised, smooth, firm scar on the upper chest on deep brown skin. It is gray-brown and only a little different from the skin around it, shiny and hairless, with edges spreading well past the small mark it grew from and a halo of flat darker marks.
LightMediumBrownDeep

Keloids are not spread evenly. They are much more common in people of African, Afro-Caribbean, Hispanic, South and East Asian, and Mediterranean descent. Published estimates for people of African descent range from about 5 to 15 percent, against a much lower figure in very fair skin. Family history is common.

So risk belongs in the conversation before any elective procedure, and usually is not. If you have deeper skin tones, a personal or family history of keloids, or keloids now, say so before ear or body piercing, a tattoo, a mole or cyst removal, a cosmetic procedure or surgery. It can change the site, the technique, how the wound is closed, and whether preventive treatment starts that day instead of months later. Some triggers matter more here. Acne on the chest, shoulders and back can heal into keloids rather than flat marks. Ingrown hairs from shaving the beard area, called pseudofolliculitis barbae, leave keloidal scarring along the jaw and neck. Inflamed bumps at the back of the scalp and neck, called acne keloidalis nuchae, occur mainly in men with tightly coiled hair and can build into a firm band of scar. Treat these while they are still inflammation rather than scar. Treatment needs adjusting. Steroid injections can leave a pale, thinned patch, and that lightening is more visible and longer lasting on deeper skin tones. Cryotherapy destroys pigment cells and often leaves permanent white marks, which is why many dermatologists use it cautiously here or not at all. Neither is a reason to skip treatment, but raise both so the plan and the dose account for it. Expect flat dark marks around a treated keloid. Inflammation on deeper skin tones leaves post-inflammatory hyperpigmentation, which takes many months to fade. Daily sunscreen keeps those marks from deepening while the keloid is treated.

Where It Shows Up

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Front view of a head with red marks on both earlobes, along both sides of the jaw and on the neck.
Earlobes, jawline and the back of the neck
Keloids form where the skin is under constant tension and movement. The earlobe after a piercing is the single most common place. The jawline and the back of the neck follow, often after acne or after ingrown hairs at the hairline.
Back view of a whole body with red marks across the upper back, both shoulders and the back of the neck. The rest of the body is clear.
Chest, shoulders and upper back
The front of the chest over the breastbone, the shoulders and the upper back are the other high-risk areas. The same wound on an arm or a leg often heals flat, which is why a keloid is about where the injury was as much as how bad it was.

What Happens in the Skin

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This is what is going wrong under the skin, in the order it happens. Click a step to see it.

How Keloids happens
Skin basics
BARRIEREPIDERMISDERMISCOLLAGEN0NORMAL SKIN1THE SKIN IS INJURED INTO THE DERMIS2INFLAMMATION RUNS ON TOO LONG3FIBROBLASTS OVERPRODUCE COLLAGEN4TENSION KEEPS THE SCAR GROWING

The dermis is the layer beneath the surface, and it is built from collagen, the fiber that gives skin its strength. In skin that has never been injured, that collagen lies in flat, orderly bundles. Nothing is being repaired, so nothing is being added.

Something breaks the skin deeply enough to reach the dermis, the layer under the surface. That can be a piercing, an operation, a burn, a deep acne spot or an insect bite. Any wound that reaches this layer sets off a scar, and this is the only step you have much control over.

Every wound becomes inflamed while it repairs, and normally that inflammation switches off. In a keloid it runs longer and hotter than it should, so the repair signals keep firing after the wound has closed.

Cells called fibroblasts answer those signals by making collagen, the fiber that scars are built from. Here they make far too much of it, in thick disorganized bundles, and they do not stop when the wound is repaired. This is the step steroid injections push on.

Because the growth is driven by signals rather than by the shape of the wound, the scar spreads sideways into skin that was never injured. Skin that is pulled and moved constantly, like the chest and shoulders, keeps feeding that growth. This is the finished keloid, and almost everything on the lists below is pushing on it.

The outer film of dead cells and oil. It holds water in and keeps irritants out, and it is thinner than a sheet of paper. Almost every dry, itchy, stinging skin problem starts here.

The outer layer, and the only one anything in a jar reaches. It renews itself constantly: a cell made at the bottom takes about a month to reach the surface and flake off. Most of what a skincare product does, it does here.

The living layer underneath, holding the blood vessels, the nerves and the collagen. It is where lasting change happens and it is hard to reach: most of what is sold for the skin never gets this far.

Four things happen, in order. The skin is injured deeply enough to reach the dermis, the layer below the surface, which is what starts a scar. The inflammation that follows runs longer and hotter than it should, so repair signals keep firing. Fibroblasts answer by making collagen, far too much of it, in thick disorganized bundles, and they keep making it after the wound has closed. Because signals drive the growth rather than the shape of the wound, the scar spreads sideways into skin that was never cut.

Two things decide who this happens to. The first is genetics: keloids run in families, track strongly with ancestry, and that risk cannot be changed. The second is mechanical: skin under constant tension or movement, like the chest, shoulders and upper back, forms them far more readily, which is why the same injury heals flat on the leg and keloids on the sternum.

No single gene explains keloids, so treatments push on the inflammation and the collagen rather than fix a cause. That is why treatment is a course and not a cure.

Risk Factors

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Most of what decides whether you form keloids was set before the injury. You did not cause this.

Inherited
Ancestry and skin tone
The largest factor. Much more common in people of African, Afro-Caribbean, Hispanic, Asian and Mediterranean descent.
Inherited
Family history
Keloids cluster in families. A parent or sibling with them raises your risk meaningfully.
Inherited
Previous keloids
The strongest practical predictor. Treat every future wound as high risk.
The wound
Site of the injury
The breastbone, shoulders, upper back, earlobes and jawline are high risk. The same wound elsewhere often heals flat.
The wound
Burns, surgery and injury
Any wound reaching the dermis can do it, and slow or infected healing makes it likelier.
The wound
Tension on the wound
Scars across a joint, over the chest, or closed under tension thicken more often.
Common triggers
Piercings
Earlobe and cartilage piercings are among the most common causes, and a keloid can appear months after one healed uneventfully.
Common triggers
Acne and folliculitis
Deep inflamed acne and inflamed follicles on the chest, back, jawline and neck can heal into keloids.
Age & hormones
Age
Most keloids start between about 10 and 30, and are uncommon in infants and older adults.
Age & hormones
Hormonal periods of life
Keloids are reported to grow during puberty and pregnancy. Consistently observed, not well explained.

Course

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Keloids follow a slow pattern, and the first months are when treatment helps most. Nothing looks unusual early, so the change often arrives months after the wound closed.

Weeks 0 to 4Healing
The wound closes normally

Nothing looks unusual yet, which is why keloids surprise people.

EarlobesChestShouldersUpper backJawlineBack of the neck
Months 1 to 3Rising
The scar thickens and often itches

It turns thicker, firmer, redder or darker, and usually itchy. This is where a keloid and an ordinary healing scar diverge.

Months 3 to 12Growing past the edge
The scar spreads beyond the original wound

It grows out into surrounding skin. Itching, tenderness and a pulling feeling are common, and this is the phase people come in with.

Year 1 to 2Firming
Growth slows but the keloid stays

It gets harder and paler but does not flatten the way a hypertrophic scar does. Most keloids stay, and some enlarge slowly for years. Do not plan around it clearing on its own.

With treatmentFlattening
Height and itch respond before the width does

Steroid injections are repeated every four to six weeks, and you judge progress over months. A treated keloid leaves a flat mark, not normal skin. Keloids come back readily, especially after surgery alone, so follow-up and repeat treatment are normal, not a sign something went wrong.

What Makes It Better & Worse

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A keloid is not one problem, it is four — a deep injury, inflammation that lasts too long, fibroblasts overproducing collagen, and tension that keeps the scar growing. You control only the first one, and almost everything that helps calms step two or slows step three.

What is driving yours?

FATCOLLAGENBARRIEREPIDERMISDERMIS

Something breaks the skin deeply enough to reach the dermis, the layer under the surface. That can be a piercing, an operation, a burn, a deep acne spot or an insect bite. Any wound that reaches this layer sets off a scar, and this is the only step you have much control over.

Every wound becomes inflamed while it repairs, and normally that inflammation switches off. In a keloid it runs longer and hotter than it should, so the repair signals keep firing after the wound has closed.

Cells called fibroblasts answer those signals by making collagen, the fiber that scars are built from. Here they make far too much of it, in thick disorganized bundles, and they do not stop when the wound is repaired. This is the step steroid injections push on.

Because the growth is driven by signals rather than by the shape of the wound, the scar spreads sideways into skin that was never injured. Skin that is pulled and moved constantly, like the chest and shoulders, keeps feeding that growth. This is the finished keloid, and almost everything on the lists below is pushing on it.

What helps

  • Treating the acne or folliculitis Controlling inflammation stops new keloids.
  • Telling every clinician It changes how they cut and close.

What makes it worse

  • Any new injury to high-risk skin Piercings, tattoos and mole removals each start one.
  • Re-piercing a keloided earlobe The surest way to make it bigger.
  • Untreated inflamed acne Every deep spot is a wound in the riskiest skin.
  • Shaving that causes ingrown hairs Repeated bumps build into keloidal scarring.
  • Surgery alone It comes back most times, often bigger.

What helps

  • Silicone sheets or gel The best-supported option without a prescription.
  • Steroid injections Triamcinolone is the standard first treatment.
  • Starting early A new, soft keloid responds far better than a hard one.
  • Laser for color and texture Vascular lasers reduce redness alongside injections.
  • Daily sunscreen over the scar Stops the marks around it from deepening.

What makes it worse

  • Picking, squeezing or scratching Restarts the inflammation.
  • Delayed healing or wound infection The longer it stays inflamed, the more the scar overshoots.
  • Rubbing from clothing or straps Backpack, bra and helmet straps irritate it.

What helps

  • Combination treatment, not surgery Surgery plus injections or radiation limits recurrence.
  • Adding another injected medicine Triamcinolone is often combined with 5-fluorouracil.
  • Cryotherapy, chosen carefully It flattens some keloids but often leaves permanent pale patches, a drawback on deeper skin tones.

What makes it worse

  • Waiting to see if it settles Old, hard keloids improve less.
  • Stopping treatment once it flattens Keloids re-thicken if you abandon the course.

What helps

  • Pressure earrings after treatment Worn for months, they cut recurrence.
  • Silicone or paper tape on a new scar Taping cuts tension for the first months.

What makes it worse

  • Tension across the scar Mechanical stress drives more growth.

How These Treatments Work

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Treatments for Keloids do not all work in the same place. Tap one to see where it acts.

Pick a treatment
Skin basics
BARRIEREPIDERMISDERMISCOLLAGENSLOWS THE OVERBUILDFLATTENS IT SLOWLYTREATS THE REDNESSREMOVES ITPREVENTS THE NEXT ONE

Tells the cells to stop laying down collagen. Usually a series, weeks apart.

Months of daily use, and best started early.

Changes the color more than the height.

Cut out on its own it usually returns larger, so it is paired with injections or radiation.

Piercings, procedures and even acne can start another one.

The outer film of dead cells and oil. It holds water in and keeps irritants out, and it is thinner than a sheet of paper. Almost every dry, itchy, stinging skin problem starts here.

The outer layer, and the only one anything in a jar reaches. It renews itself constantly: a cell made at the bottom takes about a month to reach the surface and flake off. Most of what a skincare product does, it does here.

The living layer underneath, holding the blood vessels, the nerves and the collagen. It is where lasting change happens and it is hard to reach: most of what is sold for the skin never gets this far.

Over-the-Counter Products

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Everything here you can buy without seeing anyone.

A white cream tube lying on its side on a white background, with a plain white label reading Silicone Gel and a yellow swoosh beneath it.
Silicone sheets and gel
Moderate evidence
The best-supported thing you can buy for keloids without a prescription. Worn or applied over the scar for most of the day, over months, it softens and flattens it and eases the itch. It works best on new scars and on preventing one after a wound, and it will not clear a hard, old keloid on its own.
Pressure earrings
Pressure earrings
Moderate evidence
Clip-on discs that squeeze an earlobe keloid from both sides, used mainly after a keloid has been injected or removed. They have to be worn for many hours a day for months to cut the chance of it coming back. They are uncomfortable at first, and stopping early is the usual reason they fail.
Silicone or paper tape on new scars
Silicone or paper tape on new scars
Limited evidence
Taping a fresh scar takes some of the pull off it while it is healing, which matters most on the chest and shoulders where tension keeps a keloid growing. It is used for the first few months after a wound closes. It is prevention rather than treatment, and it does nothing for a keloid that is already established.
Daily sunscreen over the scar
Daily sunscreen over the scar
Limited evidence
Sunscreen does not flatten a keloid. It stops the flat dark marks around it deepening while it is being treated, which on deeper skin tones is often what people notice most once the scar itself has settled. Use it on any keloid that clothing does not cover.
A white cream tube lying on its side on a white background, with a plain white label reading Onion Extract and a yellow swoosh beneath it.
Onion extract gel
Weak evidence
Widely sold as a scar gel, and the studies behind it are small and mostly unconvincing for keloids. Some people find it makes the scar feel more comfortable, which is not nothing. If you are choosing one product to buy, silicone is the better use of the money.
Four vitamin E oil bottles lined up on white, two amber dropper bottles and two clear yellow oils16:9 hero for Vitamin E (Tocopherol). Never cropped: the tone strip and the corner logo depend on the full frame.
Weak evidence
Rubbing vitamin E oil on a keloid is one of the most common pieces of advice given, and it has not been shown to flatten one. In some people it also causes an itchy rash where it is applied. It is not a reason to delay treatment that works.

Prescriptions

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These need a prescription.

16:9 hero for Clobetasol Propionate. Never cropped: the tone strip and the corner logo depend on the full frame.
Clobetasol Propionate
Limited evidence
A strong steroid ointment put on the keloid and covered overnight, usually to take the edge off itching between injection appointments. Covering it is what gets any of it through thick scar tissue. It will not flatten a keloid on its own, and long spells of use thin the normal skin around the scar.
A white medicated skin patch on a white background, with a plain white label reading Steroid Tape and a blue swoosh beneath it.
Steroid-impregnated tape
Limited evidence
A thin tape with steroid built into it, cut to the size of the scar and worn most of the day. It gives steady low-dose treatment plus a little pressure, and it suits small keloids and people who want to stretch the gap between injections. It is fiddly on hairy skin and can irritate the skin at the edges.

Procedures

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These are done in the office, usually over several visits.

16:9 hero for Triamcinolone Acetonide. Never cropped: the tone strip and the corner logo depend on the full frame.Diagram: how Triamcinolone Acetonide works in the skin
Strong evidence
The standard first treatment for a keloid: steroid injected directly into the scar, usually every four to six weeks. It calms the long-running inflammation and slows the cells making collagen, so itch and pain settle first and flattening follows over months. The main trade-off is a pale, thinned patch where it was given, which shows more on deeper skin tones.
16:9 hero for Surgical Excision. Never cropped: the tone strip and the corner logo depend on the full frame.Diagram: how Surgical Excision works in the skin
Moderate evidence
Cutting the keloid out works only as part of a plan. On its own it comes back in the large majority of cases, often bigger, so it is paired with injections at the time of surgery, pressure afterwards, or radiation. It is most useful for a big earlobe keloid or one that is limiting movement, where nothing else will get it flat.
Radiation after excision
Moderate evidence
A short course of low-dose radiation given within a day or two of removing a keloid, to stop the scar tissue rebuilding. For keloids that have already come back after surgery, it lowers the chance of another recurrence considerably. It is only available at some centers, and the long-term risks are discussed carefully before it is used, particularly in younger people.
5-fluorouracil injection
Moderate evidence
A second medicine mixed with the steroid, or given on its own, when a keloid is stubborn or keeps returning. It targets the collagen-making cells directly, and combining it with triamcinolone works better than steroid alone in most studies. It stings more, and it can leave the surface sore or ulcerated for a short time.
16:9 hero for Cryotherapy (Liquid Nitrogen). Never cropped: the tone strip and the corner logo depend on the full frame.Diagram: how Cryotherapy (Liquid Nitrogen) works in the skin
Limited evidence
Freezing can soften and flatten smaller keloids, and is sometimes used just before an injection to make the scar easier to inject. The problem is that freezing destroys pigment cells and often leaves a permanent white patch. On deeper skin tones, where most keloids occur, many dermatologists use it cautiously or not at all.
A patient in protective goggles lying under a large laser head positioned over their face16:9 hero for Pulsed Dye Laser (V-Beam). Never cropped: the tone strip and the corner logo depend on the full frame.
Limited evidence
A laser aimed at the blood vessels in the scar. It helps with the redness, and some people find it softer and less itchy afterwards, so it is used alongside injections rather than instead of them. It does not flatten a thick keloid, and settings have to be chosen carefully on deeper skin tones to avoid pigment change.
Bleomycin injection
Limited evidence
A chemotherapy drug used in tiny amounts inside the scar for keloids that have not responded to steroid and 5-fluorouracil. Small studies show it can flatten them. It is not widely offered, and dark spotting of the skin over the injection site is common, so it is a later option rather than an early one.

When to See a Dermatologist

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Go earlier than feels necessary. Keloids are far easier to treat while young, soft and still growing, and the usual reason one becomes hard to manage is that it was watched for a year first. Book if a scar is still thickening two to three months after the wound healed, if it has spread past the edge of the injury, if it itches, hurts or feels tight, if it is growing after a piercing, or if it sits on the chest, shoulders, earlobes, jawline or back of the neck. Book too if you have had a keloid and are planning any procedure, because preventive treatment at the time of surgery beats treatment started after a new keloid appears. Be seen promptly if a lump is growing fast, bleeding, breaking down or discharging, if it is hot and painful, or if it limits how a joint or your ear moves. A firm, growing lump with no preceding injury, or a scar that changes character, breaks down or grows unusually fast, needs examining and sometimes a biopsy. Ask whether yours is a keloid, which crosses the wound outline and persists, or a hypertrophic scar, which stays inside it and flattens.

— Dr. Schwarz, Board Certified Dermatologist

Complications

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Coming back larger after surgery

A keloid cut out on its own comes back in most people, and often larger than the one that was removed, because the operation is another wound in the same high-risk skin. Surgery is still used, but as part of a plan with injections, pressure or radiation afterwards. If someone offers to simply cut it off, ask what will be done to stop it returning.

Itch, pain and tightness

Keloids frequently itch, sting or ache, and one sitting over a joint, the chest or an ear can feel tight and limit movement. For most people this, not the look of it, is the reason to get it treated. Itch and pain usually settle before the scar flattens, so treatment often feels worthwhile well before it looks it.

Pale, thinned skin after injections

Steroid injections can leave a pale, slightly sunken patch where they were given, and on deeper skin tones that lightening shows more and can last a long time. It often improves over months. Raise it before the first injection so the dose and technique are chosen with it in mind.

Lookalikes

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Hypertrophic scar

The one that matters most. A hypertrophic scar is also thick, raised and firm, and early on the two look almost the same. The difference is the border: a hypertrophic scar stays inside the outline of the original wound and usually flattens over one to two years, while a keloid grows past that outline and stays. Ask which one you have, because it changes what treatment can achieve.

Epidermal Inclusion Cyst

Both turn up as a firm lump on or behind the earlobe, and both can follow a piercing. A cyst is a smooth ball that moves under the skin, often with a tiny dark opening on top, and it can become red and tender or leak cheesy material. A keloid is fixed scar tissue, has no opening, and grew out of the scar rather than under it.

Acne Scarring

Deep acne on the chest, back and jawline can heal into either. Ordinary acne scars are flat, sunken or slightly raised and sit exactly where each spot was. Keloidal acne scars keep growing past that spot into clear skin, become firm and rubbery, and often itch. On the chest and shoulders the two are frequently mixed together on the same skin.

Myths

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  • "A keloid is just a thick scar." A thick scar that stays inside the wound outline and flattens over a year or two is a hypertrophic scar, and it settles. A keloid grows past the edge and does not. They are treated differently.
  • "You can just have it cut off." Cut one out with nothing else afterward and it returns in the large majority of cases, often bigger. Surgery is used, but inside a plan with injections or radiation.
  • "Vitamin E, onion extract gel or scar creams will get rid of it." Widely sold, weakly supported. Silicone is the over-the-counter option with reasonable evidence, and even that flattens and soothes over months rather than removing anything.
  • "Only people with deeper skin tones get keloids." Far more common on deeper skin tones, but fair skin gets them too, particularly on the chest, shoulders and earlobes. Skin tone changes the odds, not the possibility.
  • "It will go away eventually." Most do not, and some slowly enlarge for years. Planning around that is the most common reason people arrive with a keloid that is now hard to treat.
  • "Keloids can turn into cancer." They do not. A keloid is overgrown scar tissue, not a tumor. Still, a firm lump that grew with no preceding injury should be examined rather than assumed.
  • "If I keep the wound covered and clean, I will not get one." Good wound care helps, since slow healing and infection raise the odds. But keloids are mostly genetic, and careful care does not make a keloid-prone person keloid-proof.
  • "Steroid injections thin the skin, so they are dangerous." Injections can leave a pale, thinned patch, and it shows more on deeper skin tones. A real side effect to discuss and dose for, not a reason to avoid treatment.

Questions Patients Ask

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Will my keloid ever go away completely?

Realistically, no. The goal is flat, soft and no longer itchy or painful, which leaves a flat mark rather than normal skin. Most improve a great deal; very few disappear.

Can I get my ears pierced again if I have had a keloid?

It is a real risk worth discussing rather than deciding alone. Re-piercing through or next to a keloid often makes it bigger. If you go ahead, some dermatologists treat around the piercing preventively and add pressure earrings. Going back to the same studio with no plan is the version that goes badly.

Why did I get one on my chest but not on my leg?

Site matters as much as skin. The chest, shoulders, earlobes, jawline and back of the neck are high risk, partly because that skin is under constant tension and movement. The same injury heals flat on the leg and keloids on the sternum.

Do steroid injections hurt, and how many will I need?

They sting, and a firm keloid makes it uncomfortable, but it takes seconds. Most people need several, usually every four to six weeks, and the number depends on size, site and how long it has been there. Itching and pain improve first, flattening later.

Will the injection lighten my skin?

It can. A pale, slightly sunken patch at the injection site is a recognized side effect, more noticeable on deeper skin tones, and it often improves over months. Raise it before the first injection.

I have a keloid and I need surgery for something unrelated. What should I do?

Tell the surgeon before the operation, not afterward. It changes where the incision goes, how it is closed, whether the wound is taped, and whether preventive injections are given. Ask what will be done differently because of your keloid history.

References

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