Keloid scars can be raised, firm, itchy, tender or visibly darker than the surrounding skin. They may develop after acne, piercings, burns, surgery, injury, vaccination sites or even minor skin trauma. Unlike a normal scar, a keloid can grow beyond the original area of injury and may continue to thicken over time.
At Dermé Aesthetic Clinic in Camberwell, Dr Amir Masoudi provides personalised assessment and treatment planning for keloid and raised scar concerns.
Keloid scar treatment involving steroid injection following assessment of suitability, risks and expected outcomes.
A keloid scar is an overgrowth of scar tissue that forms when the skin produces excess collagen during the healing process. Keloids can appear raised, thick, shiny, firm, red, pink, brown or darker than the surrounding skin. They can sometimes feel itchy, sensitive, tight or uncomfortable.
Keloids are different from hypertrophic scars. A hypertrophic scar remains within the original wound boundary, while a keloid can extend beyond the original injury site. This distinction is important because treatment expectations and recurrence risk can differ.
Keloids develop when the skin’s healing response becomes overactive and produces too much collagen. Some people are more prone to keloid formation due to genetics, skin type, previous scar history or the location of the injury.
Keloids are more common in darker skin tones, but they can occur in any skin type. People who have developed one keloid may be more likely to develop others after future skin trauma.
Keloid scars develop when the body’s normal wound healing process becomes overactive. After the skin has been injured, the body naturally repairs the area by producing collagen, a structural protein that helps restore the strength and integrity of the skin. In some individuals, this healing response continues for longer than necessary, resulting in excessive collagen production and the formation of a keloid scar.
When the skin is damaged by acne, surgery, piercings, burns, cuts or other trauma, the body begins a complex healing process involving inflammation, tissue repair and collagen remodelling. In most people, this process gradually slows once the wound has healed.
In patients who develop keloids, the healing response remains active for longer than normal. As a result, scar tissue continues to grow even after the original wound has closed, producing a raised scar that may extend beyond the boundaries of the initial injury.
Collagen is the main structural protein within the skin and provides strength and support during healing. Normal scars contain collagen arranged in an organised pattern.
Keloid scars develop when excessive amounts of collagen are produced and deposited within the healing tissue. This excess collagen contributes to the raised, firm and sometimes shiny appearance that is characteristic of keloid scars.
Fibroblasts are specialised cells responsible for producing collagen and other components of the skin’s supporting framework. During normal wound healing, fibroblasts become active while the wound repairs itself and then gradually reduce their activity as healing is completed.
In people who develop keloids, fibroblasts may remain active for longer than expected and continue producing collagen after the wound has healed. This prolonged activity is believed to contribute to the ongoing enlargement and thickening of keloid scars.
Not everyone develops keloid scars after a skin injury. The reasons are not completely understood, but several factors are thought to increase the likelihood of keloid formation, including:
Because keloids behave differently from normal scars, careful assessment is important before treatment. The appearance, location, symptoms and previous history of the scar all influence the most appropriate management approach.
Although keloid scars and hypertrophic scars are both raised scars, they behave differently and may require different management approaches. During your consultation, your practitioner will assess the characteristics of your scar to determine which type of scar is present.
Feature | Hypertrophic Scar | Keloid Scar |
Growth pattern | Remains within the boundaries of the original wound | Extends beyond the original wound into surrounding skin |
Cause | Excess collagen during wound healing | Excessive collagen production with prolonged wound healing response |
Appearance | Raised, firm and often red when new | Raised, firm, smooth or shiny and may appear pink, red, brown or darker than the surrounding skin |
Common locations | Any surgical wound or skin injury | Earlobes, chest, shoulders, upper back, jawline and areas prone to skin tension |
Symptoms | May be tender or itchy while healing | May be itchy, tender, uncomfortable or continue enlarging over time |
Natural course | Often becomes flatter and softer over time | Less likely to improve without treatment and may continue to enlarge |
Recurrence risk | Lower | Higher, particularly after further trauma or surgery |
Treatment considerations | Depends on the scar characteristics and symptoms | Requires careful assessment because recurrence is relatively common |
Although these two scar types may appear similar, distinguishing between them is important because treatment recommendations, expected healing and the likelihood of recurrence can differ. A comprehensive consultation helps determine the most appropriate management plan for your individual scar.
Your keloid scar treatment begins with a consultation. During your appointment, your practitioner will assess the scar, your skin type, symptoms, scar history and any previous treatments.
If the lesion does not appear typical for a keloid or if there are any concerning features, further medical assessment may be recommended before treatment.
The most suitable treatment depends on the size, thickness, location and symptoms of the keloid. Some keloids may require more than one treatment session and a maintenance approach to reduce the risk of recurrence.
Following a comprehensive consultation and clinical assessment, treatment with a prescribed corticosteroid medicine administered by injection may be recommended for selected patients with keloid or hypertrophic scars.
The treatment involves injecting a small amount of medication directly into the raised scar tissue. Corticosteroids are used to reduce excessive inflammation and suppress the overactive wound healing response that contributes to ongoing collagen production within the scar. Over time, this may help soften scar tissue, reduce scar thickness and improve symptoms such as itching, tenderness or discomfort in suitable patients.
Steroid injection treatment may be considered for selected:
Keloid scars usually develop over many months or years and contain dense collagen within the deeper layers of the skin. Because collagen remodelling occurs gradually, treatment is often performed over a series of appointments rather than as a single procedure.
The number of treatment sessions varies depending on several factors, including:
During your consultation, your practitioner will discuss an individual treatment plan and recommend appropriate review intervals based on your scar and clinical assessment.
Scar tissue continues to remodel gradually after treatment. While some patients notice changes over the weeks following treatment, collagen within the scar reorganises slowly and the response varies between individuals.
Because keloids have a tendency to continue producing collagen, repeat assessment and additional treatment sessions may be recommended where clinically appropriate. The aim of treatment is to manage the scar over time while monitoring your response and adjusting the treatment plan if required.
Not every keloid requires the same treatment approach. Depending on the characteristics of the scar, your skin type, symptoms and previous treatment history, a combination management plan may be considered.
For selected patients, treatment may include scar-supportive homecare, silicone-based scar therapy, pressure therapy where appropriate, professional skincare and ongoing clinical review. In carefully selected cases, additional treatments such as Platelet-Rich Plasma (PRP), skin needling or other procedures may be considered as part of an individualised management plan. However, not all treatment modalities are suitable for keloid scars, and recommendations are made only after a comprehensive clinical assessment.
Your practitioner will explain which treatment options may be appropriate for your individual scar, together with the potential benefits, limitations, possible risks and expected treatment course, allowing you to make an informed decision.
Not all keloid scars behave the same way. Some are newly developing, while others have been present for many years. The stage of scar development can influence treatment planning, expected treatment course and the management options that may be considered.
An immature keloid is generally a newer scar that is still actively developing. These scars may continue to increase in size, appear red or darker than the surrounding skin, and are often more likely to be itchy, tender or uncomfortable. Because collagen production is still active, early assessment may help determine whether treatment or ongoing monitoring is appropriate before the scar continues to enlarge.
A mature keloid has usually been present for a longer period and may be more stable in appearance. Although these scars can still cause cosmetic concerns or symptoms such as itching, tenderness or discomfort, they often contain denser collagen and may respond differently to treatment than newer scars. Some mature keloids require a longer treatment course or ongoing review depending on their size, location and previous treatment history.
Early assessment does not necessarily mean treatment should begin immediately. Instead, it allows your practitioner to confirm the diagnosis, assess the stage of scar development and discuss the treatment options that may be appropriate for your individual circumstances.
Your consultation also provides an opportunity to discuss:
Because every scar develops differently, treatment recommendations are individualised and based on a comprehensive clinical assessment.
Keloid scars occur in all skin types but are more commonly seen in patients with olive, Asian, Middle Eastern, African and other darker skin tones. These skin types also have a higher tendency to develop post-inflammatory pigmentation following skin injury or inflammation.
For this reason, treatment planning for darker skin requires careful consideration of both the scar itself and the surrounding skin.
During your consultation, your practitioner will assess:
Depending on your individual assessment, your treatment plan may include:
Because patients with darker skin may have a greater tendency to develop post-inflammatory hyperpigmentation or recurrent keloid formation, treatment recommendations are tailored to the individual rather than using a standard approach. A personalised consultation helps determine the management plan that is most appropriate for your skin type, scar characteristics and medical history.
Earlobe piercings are one of the most common causes of keloid scar formation. While most ear piercings heal without difficulty, some individuals develop an excessive wound healing response, leading to a raised scar that gradually enlarges beyond the original piercing site.
An earlobe keloid may appear weeks, months or even longer after the piercing. It may continue to grow over time and can become firm, itchy, tender or uncomfortable. Some keloids remain relatively small, while others become more prominent and affect the shape of the earlobe.
Early assessment is recommended if a raised scar continues to enlarge after an ear piercing. Not every lump around a piercing is a keloid, and other conditions such as hypertrophic scars, local irritation or infection may require different management.
Keloids can also develop following piercings in other parts of the body, including the cartilage of the ear, nose, navel, chest or other pierced sites. The risk varies between individuals and is influenced by factors such as genetics, skin type, the location of the piercing and any previous history of keloid formation.
Patients who have previously developed a keloid after a piercing may have an increased likelihood of developing another keloid following future piercings. During your consultation, your practitioner will assess your scar and discuss appropriate management options based on your individual circumstances.
Some self-harm scars may become raised and develop characteristics consistent with hypertrophic or keloid scars. This occurs because the body’s wound healing response may continue to produce excess collagen after the skin has healed.
Management depends on the characteristics of each scar rather than the original cause of the injury. During your consultation, your practitioner will assess the type of scar, its maturity, symptoms, skin type and previous treatments before discussing the treatment options that may be appropriate for your individual circumstances.
We recognise that self-harm scars can have significant personal meaning for some patients. Consultations are conducted respectfully, confidentially and without judgement, with treatment recommendations tailored to each individual’s concerns and clinical assessment.
The number of sessions depends on the size, thickness and age of the keloid, as well as how your scar responds. Some scars may gradually soften and flatten after a small number of sessions, while thicker or longstanding keloids may require a series of treatments.
Keloids can recur, especially if the area is irritated, traumatised or re-pierced. Follow-up appointments and maintenance advice may be recommended.
While some patients respond well to one treatment, many patients will need few treatments.
After steroid injection treatment, the area may feel tender, swollen or slightly bruised for a short period. Some clients notice gradual softening or flattening over the following weeks. Results are usually progressive rather than immediate.
Possible risks and side effects
All treatments carry potential risks. Your cosmetic doctor will discuss these with you before treatment so you can make an informed decision.
Treatment is carefully planned to reduce risk, but outcomes vary between individuals.
Keloids can often be improved, softened or flattened, but complete removal cannot always be guaranteed. Keloids have a tendency to recur, particularly in people who are prone to keloid formation.
The aim of treatment is usually to reduce the height, firmness, symptoms and visibility of the scar while minimising the risk of further irritation or recurrence.
At Dermé Aesthetic Clinic in Camberwell, Melbourne, keloid scar treatment is approached with careful assessment, realistic expectations and attention to skin safety.
A keloid scar is a type of raised scar that develops when the body produces excess collagen during the wound healing process. Unlike most scars, a keloid extends beyond the boundaries of the original injury and may continue to enlarge over time. Keloids can occur after acne, surgery, piercings, burns, cuts, vaccination sites or even relatively minor skin trauma. They may feel firm, itchy, tender or uncomfortable and can vary in colour from pink or red to darker than the surrounding skin.
Treatment depends on the size, location, symptoms and previous treatment history of the scar. Following assessment, treatment with a prescribed medicine administered by injection may be recommended for suitable patients. Some patients may also benefit from silicone scar therapy, pressure therapy, professional skincare or other scar management strategies. Your practitioner will discuss the treatment options that may be appropriate for your individual circumstances.
Yes. At Dermé Aesthetic Clinic, treatment involving steroid injection is performed by Dr Amir Masoudi following a comprehensive consultation and assessment. Before treatment, the scar is examined to confirm whether it is likely to represent a keloid or another type of raised scar and to determine whether treatment is appropriate.
The number of treatments varies considerably between patients. Factors including the size, thickness, age and location of the scar, previous treatments and your individual healing response all influence the treatment plan. Some patients require only a small number of treatment sessions, while others may require treatment over a longer period. Your practitioner will discuss an appropriate review schedule during your consultation.
Complete removal cannot be guaranteed. The aim of treatment is generally to reduce the height, firmness and symptoms of the scar while improving its overall appearance where possible. Keloids have a recognised tendency to recur, even after treatment, and some patients may require ongoing review or maintenance management.
There may be brief discomfort during injection treatment. Some tenderness or bruising can occur afterwards, but this is usually temporary.
Keloids develop because some individuals have an overactive healing response that continues to produce excess collagen even after the skin has healed. For this reason, recurrence is possible despite appropriate treatment. Follow-up reviews and avoiding unnecessary trauma to the area may help reduce recurrence risk.
Many longstanding keloids can still be assessed for treatment. The response varies depending on factors such as the age of the scar, its thickness, location and previous treatments. During your consultation, your practitioner will discuss what treatment options may be appropriate and explain realistic expectations.
Patients who have previously developed an earlobe keloid may have a higher risk of developing another keloid after future piercings. Your practitioner can discuss this risk during your consultation. In many cases, avoiding further trauma to the area may reduce the likelihood of recurrence.
Yes. Keloids may occur in younger individuals, particularly after ear piercings, surgery or skin injury. Treatment recommendations depend on the patient’s age, the characteristics of the scar and an individual clinical assessment.
Not every raised scar is a keloid. Some scars are hypertrophic scars, while others may represent different skin conditions. During your consultation, your practitioner will assess the appearance, location, history and behaviour of the scar to determine whether it is consistent with a keloid or whether further medical assessment is recommended before treatment.
No. Suitability depends on the type of scar, location, thickness, skin type and medical history. A consultation is needed to determine the best approach.
Yes. Earlobe keloids are one of the most common types of keloid scars and frequently develop after ear piercing. During your consultation, your practitioner will assess the size, thickness, symptoms and previous treatment history of the scar before discussing the management options that may be appropriate for your individual circumstances. If you have previously developed a keloid following a piercing, it is important to understand that future piercings may carry an increased risk of developing another keloid. This risk will be discussed during your consultation.
Keloid scars are more common in patients with olive, Asian, Middle Eastern, African and other darker skin tones, although they can occur in any skin type. Treatment may be appropriate following an individual clinical assessment; however, darker skin may also have a higher tendency to develop post-inflammatory pigmentation or recurrent keloid formation. For this reason, treatment recommendations, aftercare and follow-up are tailored to your skin type, scar characteristics and individual healing response to help minimise potential risks.
Following treatment, it is important to avoid unnecessary trauma to the treated area while the skin heals. Your practitioner may recommend avoiding rubbing, scratching or picking the scar, excessive pressure on the area, unnecessary friction, and activities that could irritate the treated skin. For exposed scars, protecting the area from excessive sun exposure and using a broad-spectrum SPF 50+ sunscreen may be recommended to reduce the risk of pigmentation changes. You should also follow your personalised aftercare instructions and attend any recommended review appointments so your practitioner can monitor your healing and determine whether further treatment is appropriate.
There is no single answer that is appropriate for everyone. The decision to remove recently inserted jewellery depends on several factors, including how recently the piercing was performed, whether the piercing has fully healed, the appearance of the scar and whether there are signs of infection or another skin condition.
If you notice a raised lump developing around a new piercing, it is important not to repeatedly squeeze, pick or traumatise the area, as additional irritation may worsen inflammation or scar formation. Before deciding whether to remove the jewellery, we recommend having the area assessed by an appropriately qualified health practitioner. During your consultation, your practitioner will determine whether the lump is likely to represent a keloid, a hypertrophic scar, irritation related to the piercing, an infection or another condition, and discuss the most appropriate management plan for your individual circumstances.
