Scars typically remain after injuries or surgical procedures, and their size and shape are somewhat predictable. However, many people visit the clinic with concerns like, "I've been consistently applying injections and ointments, but why isn't my scar shrinking?" If that scar is a keloid, the approach to treatment must be fundamentally different from that of a typical scar.
How are Keloid Scars Different from Regular Scars?
In a typical scar, the scar tissue flattens during the healing process. In contrast, keloids involve abnormal growth of regenerating skin tissue, extending beyond the original wound area into the surrounding skin. They appear thicker and raised compared to the surrounding skin layer and spread relatively widely, making the surface look uneven and treatment more challenging.
Due to these characteristics, simple scar injections or ointments often don't show a noticeable change. Detailed principles and treatment directions for keloid scars are also summarized in Understanding Keloid Scar Symptoms.
The Misconception That They Only Occur with Large Wounds
Because keloids are noticeably raised, it's easy to assume they only occur after severe injuries or complex surgeries. However, if there's a genetic predisposition, even small wounds can manifest as keloids, which are relatively difficult to treat.
If there's a family member who scars easily, you may have an environment that makes you more susceptible. While it's not 100% certain that a family history means you'll inherit it, checking beforehand can allow for an earlier response.
Keloids are known as scars that occur due to constitutional factors, and whether one has a keloid predisposition is difficult to know in advance before the condition develops.
Therefore, if you frequently feel swelling when you get a wound, it's best to be careful to prevent injuries from occurring in the first place.
Signs You Can Check at Home
In the clinic, many people come in only after their scars have grown larger, unaware that they have a keloid tendency. If any of the following apply to you, it's advisable to pay a little more attention to wound care:
- If there is a family member who scars prominently.
- If you have experienced a small wound scarring beyond its original boundaries.
- If a scar became firm and raised after ear piercing or a minor procedure.
- If the wound area frequently swells, itches, or feels firm.
If you observe these tendencies, we recommend being careful to avoid new injuries and seeking consultation early, before the scar hardens. For questions, please inquire via chat consultation regarding keloid predisposition.
Why Injections and Ointments Alone Have Limitations
Keloid scars rarely disappear naturally. So, the question becomes what approach is efficient. As mentioned earlier, treating keloids with injections alone has limitations.
The method itself may seem simple, but because the scar is already very firm, the tissue can tear during the procedure, causing severe pain. Also, the height of the raised scar needs to be reduced, but applying ointment may not show a noticeable change, making treatment feel very difficult.
| Category | Regular Scar | Keloid Scar |
|---|---|---|
| Extent | Heals within wound boundaries | Extends beyond wound boundaries |
| Height | Flattens over time | Rises thickly |
| Response to single injection | Relatively good | Limited due to firmness and recurrence |
Reducing Height and Recurrence
To return to a soft and smooth skin condition, the process of reducing the raised shape is first necessary. Prioritizing the return to a skin condition where injection pain is reduced and ointment efficacy can be further enhanced is important.
Another reason keloid treatment is difficult is the high recurrence rate. Injections can alleviate the extent of an already existing scar but cannot eliminate the root cause. As the duration of injection-only treatment lengthens, the amount of steroid injected inevitably increases, and the burden associated with this must also be considered.
For this reason, our clinic combines laser and injection treatments to lower the possibility of recurrence and increase treatment satisfaction. Vascular lasers block excessive nutrient supply to the scar area and suppress collagen production. This creates a skin condition that is conducive to performing secondary Triamcinolone Scar Injection. When the scar is very firm or extensive, Surgical Scar Revision may also be considered.
Not Missing the Treatment Window
Keloid scar treatment is a condition where personal care alone may feel limited. A method of minimizing the remaining form through continuous treatment is recommended. It's good to remember the following:
- Early treatment is important as it can become firmer and larger over time.
- Combining laser and injections may be more advantageous for recurrence management than injections alone.
- Treatment response and recovery may vary individually, so adjustments are made based on progress.
- If it originated from a surgical or cosmetic scar, the nature of the scar must be confirmed first.
If you are concerned about similarly raised or spreading scars, referring to Understanding Surgical Scars may also be helpful. If you are experiencing difficulties with your current treatment method, please inquire via chat consultation for keloid scar treatment.
We hope the information provided today is of some help to those concerned about keloid scars.
Chief Director Lee Sang-joo (MD, PhD, Yonsei University College of Medicine and Graduate School, completed dermatology residency at Severance Hospital, President of the Korean Dermatological Association) Chief Director Lee Sang-joo's Profile First published 2024-11-28 / Last reviewed 2026-06-16
This content is for general information purposes only, and individual treatment responses may vary. Please consult with medical staff for an accurate diagnosis and treatment plan.