Effective Keloid Scar Removal: 'This' is Important

Keloid scars, which are firm and raised above the skin, often go beyond being merely unsightly marks, frequently causing discomfort such as itching and throbbing. After experiencing recurrence, where the scar seems to improve with injection treatment only to reappear over time, the question "Will this scar never truly disappear?" is often the first to come to mind. To state the conclusion first, keloids are not a condition that vanishes at once, but rather one that requires ongoing management with the possibility of recurrence in mind.

Today, we will systematically explain why keloid scars tend to recur and what treatment principles are important to reduce recurrence.

Keloids are considered a refractory skin condition with frequent recurrence. The biggest reason is that the exact cause of their occurrence is still difficult to clearly identify.

Usually, if the root cause of a disease is known, the treatment direction becomes clear. However, for conditions like keloids, where the cause is difficult to pinpoint, complete eradication is reported to be challenging. Nevertheless, if left untreated, they tend to grow larger over time, making treatment more difficult, so early intervention is advantageous.

Once treatment begins, changes such as the raised parts of the keloid becoming flatter and its size decreasing appear from the initial stages. If you are concerned about similar issues, we recommend also reviewing Characteristics and Treatment Direction of Keloid Scars.

Even if the keloid's size has decreased and it has flattened with repeated treatments, redness often persists for some time.

If treatment is prematurely stopped at this point, assuming it has improved, it will most likely reappear. The most important principle in keloid scar removal is to continue treatment sufficiently until not only the height but also the redness subsides.

If the redness has disappeared and the height has also decreased, it is considered resolved. However, it is still necessary to closely monitor for recurrence. If any signs of re-elevation or redness appear, it is best to respond as quickly as possible.

Steroid injections are widely known as a representative treatment for keloids.

Perhaps for this reason, some patients only want to receive Triamcinolone Scar Injection. However, at our clinic, we recommend combining injections with laser treatment for keloid scar removal whenever possible.

This is because combining laser treatment with injections is reported to result in a higher treatment success rate and a lower recurrence rate than injection-only treatment. Keloids occur when excessively produced collagen accumulates in the skin, and steroid injections play the role of dissolving this accumulated collagen.

If you have any questions, please feel free to leave them via Chat Consultation for Keloid Treatment Methods.

Another important aspect of keloid scar removal is blood vessels.

Excessive collagen production requires more oxygen and nutrients. Therefore, blood vessels near the keloid abnormally expand and proliferate, which is why keloid scars appear red.

Thus, blocking the blood vessels that serve as the raw material for collagen is also important, and vascular lasers perform this role. Combining steroid injections to dissolve already formed collagen and vascular lasers to block blood vessels to prevent new collagen from forming further increases the success rate and lowers the recurrence rate.

The roles of the two treatments are summarized in the table below.

Those who have experience with keloid injections often ask if silicone gel, which has relatively less pain and cost burden, can resolve the issue when recurrence occurs and dermatological treatment feels burdensome or scary.

Silicone gel is known to aid in wound healing and symptom relief, and I agree with this point.

Although there are research results suggesting that silicone gel is helpful for keloids, based on our clinic's clinical experience, we believe it is not very helpful in practice. The exact reason is difficult to ascertain, but we suspect it is because keloid scars progress through a different mechanism than general wound healing.

Here are some helpful tips for managing keloid scars:

• Continue treatment until the redness subsides, even if the height has decreased.
• Do not stop treatment prematurely when you feel it has improved.
• Consider combining vascular laser with injections rather than injections alone.
• Respond quickly if recurrence signals (re-elevation or redness) appear.
• If itching or pain is accompanied, do not neglect it and seek medical consultation.

If you have other bothersome marks, you may also find it helpful to refer to Scar Management After Cosmetic Surgery or Surgical Scar Treatment Direction.

Today, we have summarized important treatment principles for keloid scar removal and discussed silicone gel. If you have experienced recurrence after treatment, or if the scar is gradually growing larger and accompanied by itching or pain, we recommend seeking treatment that combines laser and injection therapy.

If you have any further questions, please feel free to leave them via Keloid Scar Consultation Chat.

Dr. Sang-Joo Lee is the chief physician at Yonsei Star Dermatology Sinchon and a dermatologist who has long specialized in scar and pigment disorders. He also serves as the president of the Korean Dermatological Association in 2026 and an adjunct professor at the Department of Dermatology, Yonsei University College of Medicine. View Dr. Sang-Joo Lee's Profile First Published 2024-07-25 / Last Reviewed July 23, 2026

This article provides general information, and individual differences in keloid treatment response and progress may occur. Please confirm an accurate diagnosis and treatment direction through consultation with a dermatologist.