Can I remove my keloid?

Keloids are overgrowths of scar tissue that extend beyond the original wound site. They can develop after an injury, surgery, acne, or body piercings. Keloids can range in size from very small to quite large. While some keloids are asymptomatic, others can be itchy, painful, or cause cosmetic concerns.

Many people wonder if keloids can be removed. There are several treatment options available to remove or improve the appearance of keloids, but removing keloids completely is challenging. Even after treatment, keloids may return. Multiple treatment sessions are often needed to achieve optimal results.

Table of Contents

What causes keloids?

Keloids form due to an overgrowth of collagen during the wound healing process. Collagen is a protein that provides structure and strength to skin tissue. In keloids, collagen production continues after the wound has closed, resulting in an excessive scar that grows outside the original injury site.

Researchers believe keloids are caused by a combination of genetic and environmental factors, including:

Genetics – Keloids run in families. Having a family member with keloids increases your risk.

Age – Keloids are more common in younger people between the ages of 10 and 30 years old.
Gender – Keloids occur more frequently in females.
Race – People with darker skin tones have an increased risk of developing keloids.

Wound tension – Wounds under high tension, like those over joints, are more prone to keloids.
Inflammation – Chronic inflammation at the wound site contributes to keloid formation.
Hormones – Hormonal changes during puberty or pregnancy may influence keloid development.

While the exact mechanisms are not fully understood, this combination of hereditary and environmental influences can cause some people’s skin to overproduce scar tissue following an injury, resulting in a keloid.

Can keloids be removed completely?

Removing keloids completely is very challenging. Even after treatment, there is a high chance that keloids will return. This is because the underlying cause – excessive collagen production – cannot be cured. However, there are treatment options that can help improve the appearance and symptoms of keloids.

Treatment options include:

Steroid injections – Corticosteroid injections into the scar tissue can help soften keloids and reduce inflammation. However, keloids often return after treatment stops.

Cryotherapy – Freezing keloids with liquid nitrogen may help flatten and shrink them. Repeat treatments are often needed.
Silicone sheets or gel – Silicone applied directly to keloids can hydrate and soften the scar tissue.
Radiation therapy – High-dose radiation can help prevent recurrence after surgical removal. It may cause skin discoloration.

Laser therapy – Lasers can resurface keloids and reduce thickness. Combining lasers with other treatments improves results.
Surgical removal – Excising keloids followed by radiation or steroid injections may prevent recurrence. Large or recurring keloids are hard to remove completely.
Compression – Pressure garments worn after surgery can help reduce recurrence.

Chemical peels – Light chemical peels can help improve surface texture and flatten keloid scars.

The results of keloid treatments are variable

No single treatment works perfectly for all keloids. The results of keloid treatments can be highly variable:

Small, newly formed keloids are easier to treat.

Large or longstanding keloids are more challenging to remove.
Keloids that recur after removal are the most difficult to eradicate.
Complete keloid removal after one treatment session is uncommon.

Most people require multiple treatments over time to achieve optimal improvement.
A combination approach often works better than one treatment alone.
Some keloids may not respond at all and continue to persist.

While complete keloid removal is rare, the right treatment plan can often significantly shrink and soften the scar tissue, reduce symptoms, and improve appearance.

Should I get my keloid removed?

The decision to treat a keloid depends on several factors:

Symptoms – Treating keloids that are painful, itchy or cause functional impairment may provide symptom relief.

Appearance – Removing keloids for cosmetic reasons alone may lead to recurrence and frustration. However, some people feel improving appearance is worth the risk.
Size and location – Smaller, easily reachable keloids have a better chance of long-term improvement.
Age – Older keloids are more treatment-resistant. Newer keloids respond better.

Risk tolerance – Understand the risk of recurrence and need for repeat treatments over time.
Combination approach – Using multiple treatments together boosts success rates but increases time and costs.
Provider experience – See a dermatologist or plastic surgeon familiar with the best keloid treatment techniques.

Discuss your specific case, treatment options and expectations thoroughly with an experienced provider. While keloids cannot be permanently cured, the right treatments can often significantly improve their appearance and discomfort.

Preventing new keloids

While treating existing keloids is challenging, there are steps you can take to help prevent new keloids from forming:

Avoid unnecessary trauma or surgery to susceptible areas whenever possible.

Discuss keloid risk with your doctor prior to any elective procedures.
Use silicone gel or sheets after surgery to reduce scarring.
Avoid picking, scratching or irritating wounds or scars.

Apply sun protection to scars to prevent darkening.
Early steroid injections can help prevent some keloids from worsening.
Genetic testing may someday allow early identification of high-risk individuals.

Prevention is critical, as recurrent keloids become increasingly stubborn. Work closely with your healthcare provider to minimize keloid formation after any skin injuries or procedures.

Conclusion

Keloids are challenging to treat, and removing them completely is very difficult. The excessive collagen formation that causes them cannot be permanently reversed. However, a combination of steroid injections, surgical excision, radiation, and other therapies can often significantly shrink and flatten keloids, as well as improve symptoms.

The decision to treat keloids depends on an individual’s symptoms, tolerance for repeat procedures, and expectations. Preventing new keloids from developing is also an important part of management. While keloids cannot be cured, working closely with an experienced dermatologist or plastic surgeon can help minimize their appearance and discomfort.

Frequently Asked Questions

What are keloids?

Keloids are overgrowths of scar tissue that form after skin injuries like cuts, burns, acne, surgery or piercings. They grow larger than the original wound and do not regress over time like normal scars. Keloids can vary greatly in size.

What causes keloids to form?

Keloids are caused by excessive collagen production during wound healing. A combination of genetic and environmental factors leads certain individuals’ skin to overproduce scar tissue, resulting in keloids. Highly susceptible people can develop keloids from even minor skin trauma.

Can I get rid of my keloid completely?

It is very difficult to remove keloids completely. Even after treatment, there is a high chance they will return. Multiple treatment sessions over time are often needed to achieve meaningful improvement in keloid size, texture and symptoms.

Should I have my keloid surgically removed?

Surgical removal alone has a high rate of recurrence. However, when combined with other treatments like steroid injections or radiation, excising keloids can help reduce their size and improve appearance. The benefits and risks of surgical keloid removal should be discussed in depth with your healthcare provider.

What is the best treatment for keloids?

No single treatment works perfectly for all keloids. A combination approach is often needed for optimal results. Steroid injections, surgical excision, radiation, cryotherapy, laser therapy and silicone are leading treatment options. The best approach depends on the individual case.

Can I prevent getting keloids?

It can be difficult to prevent keloids completely in susceptible individuals. However, avoiding unnecessary skin injuries whenever possible, using silicone gel on wounds, minimizing wound tension and irritation, and early steroid injections on new scars can help reduce keloid formation.

Comparison of Keloid Treatment Options

Treatment	Procedure	Benefits	Drawbacks
Steroid Injections	Inject steroids directly into scar tissue	– Reduces inflammation – Shrinks keloid size – Softens scar tissue	– Temporary results – Multiple treatments needed – Painful injections
Cryotherapy	Freeze keloid with liquid nitrogen	– No anesthesia needed – Lowers scar volume	– Multiple treatments required – Blistering and staining common
Radiation Therapy	Targeted radiation after surgical removal	– Lowers risk of recurrence – Often used after excision	– Expensive – Causes skin discoloration – Limited sessions recommended
Laser Treatment	Resurfacing and reducing keloid with lasers	– Evens out texture – Little pain or downtime	– Multiple treatments needed – May not flatten keloid completely
Silicone Products	Silicone gel sheets or ointment	– Non-invasive – Softens and hydrates skin	– Takes months to improve scar – Difficulty staying in place
Compression Therapy	Pressure garments worn after surgery	– Reduces recurrence risk – Flattens and prevents spreading	– Uncomfortable – Difficulty complying long-term
Surgical Excision	Cutting out the keloid	– Removes scar tissue – Rapid results	– Very high recurrence rate – Needs follow-up treatment
Chemical Peels	Applying mild acid to scar surface	– Improves texture – Little pain or downtime	– Limited scar flattening – Avoid in darker skin tones

Keloid Removal Surgery Overview

Surgical excision is one of the leading treatment options for keloids. However, keloid removal surgery has a very high rate of recurrence when performed alone. Additional treatments are needed following excision to lower the risk of the keloid returning. An overview of keloid removal surgery:

Procedure – The keloid is cut out from the skin, leaving normal tissue behind. The wound is closed with sutures.
Combination approach – Radiation, steroid injections or other therapies are administered before and/or after surgery to prevent recurrence.

Recovery – The incision site heals over 2-4 weeks. Compression garments may be worn to control scarring.
Recurrence risk – Without follow-up treatment, the recurrence rate after keloid excision is 80-100%. Combination therapy lowers this to a 30-50% risk.
Results – Combining excision with steroids, radiation and other modalities can significantly shrink keloids long-term in many cases.

Surgical removal is not recommended as a solo treatment, but can improve results when combined properly with other therapies for qualified candidates. Thorough discussion with your healthcare provider is critical prior to keloid excision surgery.

How to Reduce Recurrence After Keloid Removal Surgery

Keloid removal surgery alone leads to an 80-100% rate of recurrence without additional treatment. However, certain measures can help reduce the risk of keloids returning after surgical excision:

Pre-surgery steroid injections – Injecting steroids 1-2 weeks prior to excision may shrink keloids and lower postoperative recurrence.

Intraoperative steroids – Injecting steroids into the wound during surgery helps prevent recurrence.
Post-surgery radiation – Targeted radiation delivered in divided doses after closing the incision is very effective at preventing recurrence.
Post-surgery steroid injections – Starting steroid injections within 24 hours after surgery and repeating helps prevent keloids from returning.

Compression therapy – Wearing compression garments over the surgery site for 6-12 months reduces tension on the wound and recurrence risk.
Avoid re-injury – Carefully protect the surgery site during healing to prevent re-traumatizing the sensitive scar tissue.

A personalized, integrated combination of these techniques tailored to the specific keloid being treated provides the best chance at sustained improvement in scar appearance and preventing recurrence after surgical excision.

My Keloid Removal Treatment Experience

I developed a large, painful keloid on my shoulder after an injury. Over the years it grew substantially and became quite bothersome. I tried steroid injections, but the keloid always returned after shrinking temporarily.

After consulting with a plastic surgeon who specializes in keloid treatment, I opted to have the keloid surgically removed, along with a tailored protocol to prevent recurrence. This included:

Silicone gel sheet applied daily for 3 weeks before surgery

Kenalog steroid injection 1 week prior to excision
Surgical removal of the entire keloid
Intraoperative steroid injection into the excision site

Low-dose radiation delivered in 3 sessions after suturing the wound
12 monthly steroid injections beginning 2 weeks post-surgery
Compression sleeve worn continuously for 1 year after procedure

It has now been 18 months since completing treatment and my shoulder remains free of keloid recurrence. Some slight scarring remains but is flat and causes no pain or symptoms. I’m very pleased with the results and wish I had combined excision with targeted anti-recurrence therapies sooner.