Keloid Scars. Everything you need to know

We offer evidence-based treatments for all types of scars including keloid scars

Keloid scars are a form of abnormal wound healing where scar tissue grows beyond the boundaries of the original injury. They can continue to enlarge over time and may be associated with symptoms such as itch, tenderness, or pain.

Dermatologists who consult at Northside Dermatology provide assessment and management of keloid scars using evidence-based approaches. Treatment plans are individualised and may involve a combination of therapies. Results vary depending on individual skin response, treatment type, and clinical diagnosis.

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Keloid Scars

Treatments

What are Keloid Scars?

A keloid scar is a raised, thickened scar that extends beyond the original wound edges. Unlike other scar types, keloids do not regress on their own and may continue to grow months or years after the initial skin injury.

Keloids may develop after relatively minor trauma, including acne lesions, piercings, injections, surgical incisions, burns, or tattoos. In rare cases, they can arise without an identifiable trigger.

How Keloid Scars Differ From Other Raised Scars

Keloid scars differ from hypertrophic scars in several important ways:

They grow beyond the original wound boundary
They are more likely to persist long term
They have a higher risk of recurrence after treatment

Because of these characteristics, keloid scars often require more intensive and carefully planned management.

Areas Commonly Affected

Keloid scars can occur anywhere on the body, but are more commonly seen on:

Earlobes (often following piercings)
Chest and upper sternum
Shoulders and upper back
Jawline and neck

Certain body sites are associated with a higher risk of recurrence following treatment.

Keloid Scar Treatments

There is no single treatment that is suitable for all keloid scars. Dermatologists who consult at Northside Dermatology may recommend one or more of the following options, often in combination.

Intralesional Injections

Corticosteroid injections may help reduce thickness, firmness, and symptoms such as itch or pain. Other prescription medicines may be added in selected cases to improve response in thicker or recurrent keloids. Treatments are typically administered at intervals of 4–6 weeks as part of a planned course.

Best for: Active or symptomatic keloids

Down time: Minimal

Fractional CO₂ Laser

Creates controlled micro-injuries within the scar to support collagen remodelling. May help improve texture and integration with surrounding skin. Can enhance penetration of injected or topical medicines into scar tissue.

Best for: Thickened or firm keloids

Down time: Variable

CO2 Laser Skin Resurfacing Treatment

Vascular Laser Therapy

Targets blood vessels that contribute to redness and ongoing scar activity. May reduce redness and support gradual flattening when combined with other treatments.

Best for: Red or inflamed keloids

Down time: Minimal to mild

Medical Treatments with Lasers

Minimally Invasive Shave Excision

May be considered for carefully selected small keloid scars. Aims to reduce excess scar bulk while preserving surrounding tissue. Usually followed by injections and/or laser therapy to reduce recurrence risk.

Best for: Small, well-defined keloids

Down time: Short recovery period

Supportive and Adjunctive Therapies

Supportive measures may be recommended alongside in-clinic treatments, including:

Silicone gel or silicone sheets applied at home
Pressure therapy, such as pressure earrings for ear keloids
Cryotherapy (freezing treatment) for selected smaller or firmer scars

These approaches are typically not used alone for established keloid scars.

Why Combination Treatment Is Often Recommended

Keloid scars have a higher tendency to recur compared with other scar types. For this reason, dermatologists who consult at Northside Dermatology rarely rely on a single treatment modality.

Combination or staged treatment plans may be used to:

Reduce scar thickness and firmness
Improve colour and texture
Relieve associated symptoms
Lower the likelihood of regrowth

Treatment selection is guided by scar characteristics, location, previous treatment response, and individual risk factors. Results vary depending on individual skin response, treatment type, and clinical diagnosis.

Arranging an Assessment

Assessment by a dermatologist is important for raised scars that are changing, symptomatic, or causing concern. Dermatologists who consult at Northside Dermatology can provide individualised advice on diagnosis, treatment options, and expected outcomes.

To explore suitable management options, contact Northside Dermatology on 03 8582 8688 to arrange an appointment with a dermatologist.

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Frequently asked questions

What does a keloid scar look like?

Keloids are large, thickened scars that project outward from the skin and extend beyond the boundaries of the initial injury. They are smooth-surfaced and firm, and may be pink, red, brown or skin-coloured. There is substantial variation in the size and shape of keloid scars. Some can become bulbous and disfiguring, causing emotional distress and potentially restricting movement.

What causes keloid scars?

The cause of this type of abnormal scarring is not completely understood. Not everyone who gets a scar will form a keloid. Keloid scarring most often develops as a result of excessive collagen production after a skin injury such as a cut, burn, piercing, tattoo, acne, injection or surgery. A keloid usually takes time to emerge after the injury takes place, appearing gradually over the course of months. The original wound does not have to be significant for a keloid scar to form. In very rare cases, keloid scars can appear spontaneously.

Where do keloid scars tend to develop?

Keloid scars can occur anywhere, but certain areas of the body are more prone to keloid development. These include the ear lobes, shoulders, chest, upper back, elbows and knees.

Who is more at risk of developing a keloid scar?

Genetics, ethnicity, age, wound location and the type of injury all play a role in the kind of scarring that occurs. Those who are particularly at risk for keloid scarring are:

Individuals with a personal history of keloid formation
Individuals with a family history of keloid formation
Individuals with skin of colour

What problems can occur with keloid scars?

Keloid scars are mostly a cosmetic concern. They do not turn into skin cancers or pose a threat to your general health. However, some keloids cause itching, pain and a tight pulling sensation in the skin. If the keloid forms over a joint or covers a large area, it can make it harder to move that part of the body.

Will a keloid scar go away on its own?

A keloid scar will not resolve spontaneously. It can be improved with treatment by a specialist dermatologist.

How is a keloid scar diagnosed?

Professional assessment is essential for appropriate diagnosis and treatment of a scar that causes concern. A dermatologist can usually diagnose keloid scarring with a visual examination. A skin biopsy may be required to confirm the diagnosis in some circumstances.

How can keloid scarring be prevented?

Keloid scars can be challenging to treat. If you scar easily, prevention of keloid formation will yield the best outcomes. The risk of keloid scarring can be reduced by:

Avoiding planned injury to the skin (e.g. tattoos, piercings, cosmetic surgery)
Treating skin conditions, such as acne, that occur on keloid-prone areas
Using techniques that reduce tension on the skin after surgery
Administering intralesional steroid injections at the time of surgery
Applying silicone gel topically to the healing skin

How can a keloid scar be treated?

Patients interested in reducing the visibility of existing keloid scars have various treatment options:

Intralesional steroid injections
Intralesional 5-fluorouracil injections
Injection with a combination of the above two agents
Vascular laser treatment to address the inflammatory component of the keloid
Resurfacing lasers including CO2 laser and or 1927nm thulium laser
Long-term use of pressure dressings and silicone sheets or gel
Steroid ointment applied under occlusion to reduce itch and flatten the scar
Surgical excision combined with intralesional steroid injection when conservative measures are inappropriate or ineffective
Radiotherapy

Your Scar Solution Awaits

Struggling with scarring? Our expert dermatologists offer tailored scar treatment plans, from medical therapy to cutting-edge laser technology like CO2 resurfacing. We’re here to help you achieve clearer, healthier skin that lasts.

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Northside Dermatology operates in state-of-the-art facilities in Fitzroy North and Reservoir. All acne treatments are performed by trained doctors or dermatologists, ensuring your skin is in the safest hands.

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