Keloids are scars where the skin becomes red and firm, swelling up in the place of a healed wound. Patients encountering them for the first time often ask similar questions: "Will this just go away on its own?" To answer directly, keloids rarely subside naturally; instead, they tend to grow larger over time or be accompanied by itching and pain. Therefore, accurately understanding the symptoms and condition and establishing a suitable treatment direction is paramount.
Why Do Keloids Form, and How Do You Recognize Them?
Keloids occur when collagen is excessively produced during the wound healing process. They commonly start in areas where severe acne occurred, ear piercings were made, or at surgical or trauma sites. The patient in the first story of this text also appears to have acne and keloid scars resulting from it.
If a wound area is red, swollen, firm, and itchy, it's advisable to consider the possibility of having a keloid predisposition.
Keloids originating from acne, if mild, can be attempted with injections alone. However, if the effect is insufficient or symptoms are severe, better results are reported when laser and injections are performed together. We recommend not worrying too much and receiving treatment tailored to your condition.
Ear Keloids: The Path Varies with Size
Ear keloid scars that form in pierced areas have treatment methods that vary according to their size.
If the size is small, improvement is possible with Triamcinolone Scar Injection alone. Therefore, it is advantageous to visit early and start treatment promptly. On the other hand, keloids that have grown to the size of a bean often have limitations with injections alone and are cosmetically bothersome. In such cases, surgical treatment or laser treatment is considered.
Surgery vs. Laser: What's the Difference?
The differences between the two methods are summarized at a glance below:
| Category | Method | Characteristics |
|---|---|---|
| Surgical Treatment | Excising and suturing the keloid area | Removed at once, but keloids tend to recur |
| Laser Treatment | Precisely removing keloid tissue with a laser | More precise than a scalpel; in our clinic's experience, recurrence is relatively less reported |
Surgical Scar Revision is a method of directly excising and suturing the keloid area. While it has the advantage of removing the keloid at once, the tendency for keloid scars to recur must also be considered.
Another method is to remove keloid scars with a laser. Lasers allow for more precise access than a scalpel, so in our clinic's experience, the recurrence rate is relatively lower. If you want to quickly remove a bean-sized keloid, as in the story, we recommend removing it at once with a laser.
For questions, inquire via keloid scar treatment chat consultation
Look for These Signs Promptly
When a keloid is about to grow, several signs appear together. In the examination room, when two or three of the following items overlap, progression is often rapid:
- The wound area swells up red
- It feels firmer than usual
- Itching is accompanied
- The color gradually becomes redder
- The scar spreads beyond the initial wound area
If it becomes itchy and redder like this, we recommend receiving injections and laser treatment as soon as possible. This is because keloid scars themselves become more challenging to manage over time.
Why Injections and Lasers Are Used Together
For keloid symptoms, injection treatment is generally performed frequently, and in some cases, lasers are combined. Especially when the redness is severe, lasers like Vbeam Prima are used together with injection treatment.
However, quite a few people say they can no longer receive injections at other clinics due to pain. Keloid injections, due to the nature of injecting medication into firm tissue, tend to be accompanied by pain.
If Pain Is a Concern
There are several ways to reduce pain during injections, and using these methods is reported to reduce the pain of existing keloid injections by about 10 to 30%.
This is called a low-pain injection method, and it helps to significantly reduce pain. Since keloid symptoms appear differently in each person, it is best to visit early and receive treatment tailored to your condition. If the scar originated from acne, considering it along with Acne Scar Treatment is also an option.
If you have been delaying treatment due to concerns about injection pain, feel free to check your condition first.
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Written by Representative Director Lee Sang-joo · Dermatologist
As the representative director of Yonsei Star Dermatology Sinchon, he serves as the president of the Korean Dermatological Association in 2026 and also works as an adjunct professor in the Department of Dermatology, Yonsei University College of Medicine. He has long specialized in pigment and scar treatment.
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First published October 29, 2024 · Last reviewed July 23, 2026
This article provides general medical information. The course of keloids may vary depending on individual constitution and body area. Please consult a dermatologist for an accurate diagnosis and treatment plan.