08/12/2025
Keloids: Understanding the Treatment Process
Not all scars behave the same. Keloids grow beyond the original injury. They continue to build excess collagen, becoming firm, elevated, and sometimes itchy or painful. Keloids do not regress on their own and typically require medical treatment.
In this case, these patients presented with keloid formation on the ear after piercing and another in the umbilical region following laparoscopic surgery. Because keloids are driven by ongoing collagen overproduction, treatment is performed in stages.
Stage 1: Control of the active keloid
We begin with intralesional injections over several weeks to reduce inflammation, soften the scar, and suppress collagen activity. This step helps decrease recurrence risk and prepares the tissue for surgery.
Stage 2: Surgical excision
Once the keloid becomes less active and significantly reduced in thickness, we proceed with careful excision. Surgical removal alone has a high recurrence rate, which is why pre-treatment with injections is essential.
Stage 3: Maintenance and prevention
Depending on the patient’s risk profile, we may continue with additional injections, silicone therapy, pressure therapy, or other modalities to minimize the chance of regrowth.
By combining medical therapy with precise surgical technique, we can significantly improve both function and appearance while reducing recurrence risk.
