Keloid scars: What are my treatment options?

Written in association with: Dr Richard Shaffer
Published: | Updated: 06/03/2024
Edited by: Aoife Maguire

Keloid scars can go deep into the skin, causing some people to feel self-conscious and searching to find the best solution to improve their appearance. Leading specialist in radiotherapy for non-cancer conditions Dr Richard Shaffer explains what they are and what treatment options are available.
 

What are keloid scars?

 

Keloid scars are made up of tough, bulky scar tissue that extends beyond the area of the original skin injury. They form when scar tissue carries on growing rather than healing. They tend to start as raised, red and inflamed areas, later becoming a more normal skin colour as they settle down. Their appearance is the main issue for most people, but they can also be itchy or painful.

 

 

Are there any specific risk factors or conditions that make individuals more prone to developing keloid scars, and if so, what are they?

 

Keloid scars are most common in dark-skinned people (in around 5-10%) compared with light-skinned people (less than 1%) and the average age when they appear is 10 - 30 years old. Sometimes other family members have had abnormal scars, and there may be a number of inherited genes that can cause them.

 

Are keloid scars preventable? What measures can be taken to reduce their likelihood of forming?

 

Keloids tend to form in response to damage to the skin, such as injury, surgery, acne, body piercing, tattoos, vaccinations (e.g. BCG) and insect bites.

 

Hormones can also play a part, such as sex hormones, for instance in polycystic ovary syndrome (PCOS) and thyroid hormone imbalances. High blood pressure can also be involved. Dealing with these factors may also help to stop these scars from growing.

 

Keloids often occur in areas where the skin is under tension, such as the chest and upper back. This indicates that certain heavy and repetitive physical activities may contribute towards their formation.

 

It is important to note that people who have previously had keloid scars should avoid unnecessary skin trauma, such as body piercing or tattoos.

 

What are the most effective methods for treating keloid scars? Can they be completely removed?

 

There are two main approaches to dealing with keloid scars:

 

  1. There are treatments that can improve the symptoms and size of the scar without removing it. For instance, steroid injections can be given to reduce the bulk of the scar. However, these injections do have side effects. They may cause the skin to change colour and unfortunately, 50% of scars will regrow after treatment. The effectiveness of steroids can be increased by using laser treatment before their application.

 

  1. The most definitive approach, particularly for large and troublesome scars, is surgical removal (excision) of the whole scar, followed by radiotherapy treatment shortly afterwards. Having surgery alone results in a high chance of the scar coming back (in around 80% of cases), therefore radiotherapy is used within 1-2 days after the surgery as it stops the scar from returning in the vast majority of cases

 

If you require keloid scar treatment and would like to book a consultation with Dr Shaffer, simply visit his Top Doctors profile today.

By Dr Richard Shaffer
Clinical oncology

Dr Richard Shaffer is a leading radiotherapy specialist and clinical oncologist based in London and Surrey. He has a specialist interest in treating benign (non-malignant) conditions with radiotherapy, including Dupuytren's disease, Ledderhose (plantar fibromatosis), plantar fasciitis, insertional Achilles tendonitis and keloid scarring.
 
He was the first in the UK to treat patients with osteoarthritis (of the hand, hip, knee, foot, elbow, shoulder), tendinopathy (including tennis elbow, golfers elbow, patellar tendonitis, rotator cuff syndrome, de Quervain’s tendonitis) and bursitis (including trochanteric bursitis or greater trochanteric pain syndrome, GTPS). He also treats patients post-operatively with radiotherapy for heterotopic ossification and pigmented villonodular synovitis (PVNS). He uses the latest radiotherapy technology to do this.
 
Dr Richard Shaffer is president of the International Organisation for Radiotherapy for Benign Conditions. He is clinical lead for benign radiotherapy for GenesisCare UK. He is co-author of a 2015 and 2023 Royal College of Radiologists documents on the use of radiotherapy for benign conditions, and on the most recent German benign radiotherapy guidelines. Dr Richard Shaffer previously worked as the clinical lead for radiotherapy in Guildford and he chaired The Network Radiotherapy Group and the Radiotherapy Strategy Group.
 
Dr Richard Shaffer has also chaired the Radiotherapy Technology Development Group and led the Brain Tumour Working Group from 2010 to 2019. Dr Shaffer was the principal investigator on several treatment studies in prostate cancer, skin cancer and brain tumours. He supervised a clinical fellow in a programme of clinical and lab-based radiobiological research. Before working at Royal Surrey County Hospital, Dr Richard Shaffer undertook his oncology training in London and later completed a Clinical Fellowship in Radiation Oncology (treatment of cancer with radiotherapy) in Vancouver, Canada. Whilst in Canada he completed several research projects focused on technical radiotherapy, including the comparisons of VMAT with conventional IMRT therapy and RapidArc in several disease sites such as breast, prostate and high-grade glioma.

Dr Shaffer treats patients throughout the UK. Consultations can be arranged by email for the following locations:

  • GenesisCare Bristol
  • GenesisCare Southampton
  • GenesisCare Windsor
  • GenesisCare Elstree
  • GenesisCare Guildford
  • GenesisCare Birmingham
  • GenesisCare Maidstone
  • GenesisCare Milton Keynes
  • GenesisCare Cambridge
  • GenesisCare Chelmsford
  • GenesisCare Nottingham
  • GenesisCare London Cromwell Hospital
  • GenesisCare Oxford
  • GenesisCare Portsmouth

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