If a healed wound area becomes firm, rises beyond its original size, and turns red, a keloid scar can be suspected. Many people's first question is, "Will it just keep getting bigger if I leave it?" Keloids tend to spread beyond their borders over time, so prompt evaluation is recommended rather than neglect.
Keloid Scars: How Are They Different from Regular Scars?
Keloids are constitutional scars that arise when collagen is excessively produced during the wound healing process, causing them to rise beyond the original wound area. They often occur in areas with high skin tension, such as the ears, chest, shoulders, arms, and abdomen, and can start from small wounds, acne, or piercing marks.
Keloids are known not just as simple scars but as constitutional conditions with a high tendency to recur.
They are sometimes confused with hypertrophic scars, but the two types of scars progress differently. The table below summarizes the differences.
| Category | Keloid Scar | Hypertrophic Scar |
|---|---|---|
| Extent | Expands beyond original wound borders | Remains within the wound area |
| Course | Slow to improve naturally | May subside over time |
| Common Sites | Chest, shoulders, ears, etc. (high tension areas) | Relatively fewer site restrictions |
Why Is Injection-Only Treatment Insufficient?
In clinical practice, it is not uncommon for patients to receive injection treatment, improve for a while, and then return when the scar rises again. It is reported that keloids have a high probability of recurrence if only injection treatment is performed. This is because reducing the scar tissue itself and suppressing the proliferation of blood vessels in that area are different challenges.
Therefore, Yonsei Star Dermatology Sinchon does not perform low-pain injections as a standalone treatment. To address both the raised scar and redness, we use a combined approach that simultaneously applies low-pain keloid treatment and laser. The focus is on preventing excessive scar regeneration to suppress recurrence.
What is Low-Pain Keloid Treatment (Low-Pain Injection)?
Low-pain keloid treatment is an injection therapy that helps reduce the height of raised scar areas while significantly reducing the pain felt during the procedure. More detailed information on keloid injection treatment can be found in the Triamcinolone Scar Injection guide.
- Helps to gradually reduce the height of raised scars
- Reduces pain burden, increasing treatment adherence
- Repeated at set intervals, with progress observed
- Reported to be more effective in suppressing recurrence when combined with laser than when performed alone
For questions, inquire via chat consultation regarding keloid scar treatment
Combined Keloid Treatment with Laser
Combined keloid treatment involves improving redness and suppressing vascular proliferation with a laser to prevent scar progression, while simultaneously targeting the scar area precisely to reduce the raised portion. Redness and facial flushing patterns commonly associated with keloids are also addressed during the laser stage.
When these two treatments are combined, both scar height and redness can be managed, and reactions like vasodilation are known to be low. However, the number of treatments and the degree of response may vary individually. For a general explanation of keloid scars, please refer to the Keloid Scar Symptoms Guide.
If Your Keloid Started from a Surgical Scar
It is also common for keloids to grow in surgical scar areas, such as after C-sections or thyroid surgery. In such cases, we consider a phased combination of Surgical Scar Revision to refine the scar texture itself, along with injection and laser treatments. The sequence of approach depends on the scar's location, thickness, and progression.
Things to Know Before Treatment
Keloids can grow larger if delayed, so it's better to get an evaluation when changes are observed. Keeping the following in mind can be helpful:
- If the scar spreads beyond its borders, or is itchy and prickly, medical consultation is recommended
- Often requires repeated treatments rather than a single procedure to observe progress
- Due to constitutional factors, management with recurrence possibility in mind is necessary
- Treatment response and progress may vary individually
For keloid scar removal, timely evaluation is paramount, so do not delay.
For questions, inquire via chat consultation regarding keloid scar treatment
This article was reviewed by Chief Director Dr. Lee Sang-Joo, a dermatologist. As the chief director of Yonsei Star Dermatology Sinchon, he has long specialized in pigment and scar treatments and serves as the president of the Korean Dermatological Association in 2026. First published 2024-04-09 · Last reviewed July 23, 2026
This article provides general medical information, and treatment methods and results may vary depending on individual skin conditions. Please consult a dermatologist for an accurate diagnosis and treatment plan.