keloid scars removal treatment

Keloid Scar Removal

Are your keloids causing you pain, itchiness or increasing in size?

Improve your keloid scars with clinically effective treatments.

back acne keloid scars
Back keloid scars

What is a Keloid Scar?

A keloid scar is a irregular formation of scar tissue. Through an exaggerated healing response, excess of collagen and scar tissue results in these type of scars. Triggering factors include skin trauma (burns, tattoo, ears piercing, cuts), infection and inflammation.

This abnormal wound healing process is more common in Chinese, Blacks and Hispanics and there may be a genetic tendency to develop such scars.

The development of a keloid scar is not only cosmetically disfiguring, but may cause pain and itchiness to an individual. In some cases, the scar may be infected or even form an ulcer. Areas such as the ears, chest, shoulders and upper arms are areas prone to forming keloids. Keloids may develop months to a year after injury, and do not resolve spontaneously.


Keloid Scar Removal

Keloid scar removal is a specialized medical procedure aimed at treating keloids, which are raised, thickened areas of skin that develop at the site of a wound or incision and extend beyond the boundaries of the original injury. This condition can cause physical discomfort, functional impairment, and significant emotional distress due to its appearance.

As a clinician with more than 15 years of experience, Dr Ng. understands the impact of how keloids can affect an individual. Dr. Ng provides multiple and combination treatment options that is backed by the latest scientific evidence as well as his own wealth of experience to create a care plan for the best keloid scar removal treatment that is unique to your condition. 

hypertrophic scar treatment singapore
Hypertrophic Scar

What are Hypertrophic Scars?

Keloids develop and extend beyond the original site of injury. They do not spontaneously disappear, and the extension of tissue outwards may resemble a crab claw.

On the other hand, Hypertrophic scars tend to be confined within the borders of the initial skin injury. They can resolve by themselves over months to years. Like keloids, they feel itchy and painful. Hypertrophic-keloid scars may present scarring on a spectrum of wound healing response. Treatment of hypertrophic scar is similar to that of keloids.

What Causes Keloids?

The exact cause of keloid formation is unknown. There appears to be a loss of the normal mechanism between tissue repair and regeneration. Keloids are more common in areas that experience higher skin tension; the chest, jawline and shoulders.

Although there is no definitive answer as to why some patients develop keloids while others do not, some factors include: 

  • Chronic inflammation (e.g. acne)
  • Repeated skin trauma (e.g. ear piercings)
  • Family history of keloids – there appears to be a genetic predisposition in some individuals
  • Skin colour- keloids are more prevalent amongst patients with darker skin type

Keloids can also occur spontaneously even if there are no apparent risk factors.

What Do Keloids Look Like?

jawline keloid
Jawline Keloid from Acne
sternal keoids
Multiple Chest Keloids
shoulder keloid
Shoulder Keloid

Keloids take on different shapes and sizes. They can range from less a centimetre to several centimetres in length. They are firm to touch, but can soften after treatment. Although they are usually pink to purple in colour, they can get get hyperpigmented or hypopigmented (after steroid treatments).

Keloids may be symptomatic, causing itchiness, discomfort and a tight sensation. Besides being cosmetically unpleasant, symptomatic keloids may affect an individual’s quality of life.

How Are Keloids Diagnosed?

Keloids are diagnosed based on the clinical history and appearance on examination. They are usually raised with varying consistency from hard, firm and pliable to touch.

How Do You Prevent Keloids?

If you have risk factors of developing keloids, you should avoid unnecessary piercings, tattoos and surgery.

One of the most common causes of keloids is due to chronic acne vulgaris in Asian skin type. Therefore, it is essential to treat your acne early to prevent keloids for occuring in the first place.

what is associated with keloids?

  • Wound tension e.g. chest, shoulders, jawline
  • Uncontrolled Hypertension
  • Thyroid/Adrenal disease
  • Polycystic ovarian syndrome (PCOS)
  • Overactive immune states
  • Genetics

Benefits of keloid scar removal

Keloid scars can become painful and itchy. Treatments can help alleviate these symptoms that causes interference in daily activities.

Over time, keloids can increase in size if left untreated. Timely intervention delays growth and symptoms of keloids.

Keloids are irregular scars that look red and feel bumpy. Keloid treatments can reduce the size of the scar, improve skin texture and colour.

Keloids are known to recur despite treatment. A long term maintenance approach taking into account your type of keloid, skin condition and aesthetic goals are important.

Keloids are not only physical scars, but can cause mental anguish and distress. Improving the appearance of keloids can improve self-esteem and well-being.

A combination patient-centered approach is undertaken to improve keloid appearance and related symptoms. Injection steroids may be combined with laser treatments to best treat your keloids.

Don’t let keloids stop you from living your life to the fullest. Management of keloids can help improve social interaction, professional engagement and enhance relationships.

Keloid Scar Removal

Keloid scar removal remains a challenge, despite the varied treatment options. The type of treatment used will depend on factors such as age, size of the scar, thickness and location of the scar.  

Common keloid scar removal treatments include silicon gel sheets, applying compression to the scar, and steroid injections.

Silicone gel sheets and dressing work by occlusion, and providing hydration to the scar. Silicone treatment appear to be more helpful to prevent the formation of keloid scar rather than treating established keloid. A variety of compression devices and materials have been used for individuals with keloids. This include bandages of various materials (e.g Lycra), and a variety of pressure garments. The pressure reduces the collagen bundles from sticking together, and improves scarring. One clinically and cost effective way is using micropore tape for 8-12 weeks to enable healing.


Advanced Treatment Options:

More advanced keloid scar removal options include :

  • Cryotherapy: Freezing the keloids may help to flatten it but it’s very painful.
  • Vascular Laser: to reduce the microvasculature associated with the keloid. The ADVATx laser, which wavelength is in the pulsed dye range, is FDA-approved to treat scars.
  • Injections: Bleomycin, Verapamil, Hyaluronic acid, Hyaluronidase and Botulinum toxin injection
  • Fractional Laser Resurfacing: Stimulates healing and skin texture improvement
  • Surgery excision: This option will usually result in a larger keloid scar and it is usually combined with injection steroids, radiation etc.
steroid injection for keloid singapore
Steroid injection for keloids

steroid injection

Steroid injection for keloids reduces abnormal collagen and inflammation. Either as a standalone treatment, or in combination with other keloid removal modalities such as laser treatment, your keloids will flatten and soften after a series on monthly treatments.

In addition, injection steroids are beneficial where keloids are causing you physical symptoms such as pain and itchiness.

Repeated treatments are spaced about 4-6 weeks if keloids are especially recurrent and causing lots of symptoms.

laser resurfacing

Laser works by emitting energy within the skin to treat your keloids without damage to the surrounding skin structure. Laser treatment of keloid scars addresses various issues such as:

  • Stimulating healing process
  • Reduces redness and hyperpigmentation
  • Reduces thickening and hardening of your keloid

Multiple laser session are necessary, and often in conjunction with steroid injections for the best keloid treatment outcome.With various lasers to choose from, Dr.Ng will help you customise a unique treatment plan based on your skin type, severity of your keloids and goals in mind.

fractional laser treatment for keloids
Laser resurfacing for keloids
botox keloid treatment
Commonly used botulinum toxin for medical and aesthetic purposes

Does Botulinum toxin Help with Keloids?

There is emerging evidence that botulinum toxin (Botox, Dysport, Xeomin etc) may improve the appearance of keloids and even reduce symptoms such as pain and itch for keloid sufferers. 

Although botulinum toxin has been established in the medical and aesthetic fields, it has shown growing utility in scar management through its action of relieving tension around the scar and reducing collagen formation.

The possible mechanisms includes:

  1. Reduce fibroblast activity – these are the cells responsible for producing collagen
  2. Alleviate tension around the wound by paralyzing the surrounding muscles. 

The biggest advanatge of botulinum toxin over steroid injections for keloids would be avoiding the well know steroid side effects such as skin thinning, visible blood vessels and skin discolouration. However, further research is still needed to determine if this modality of treatment will be useful in keloid scar management.

Frequently Asked Questions About Keloid Scar Removal

A topical anaesthetic cream is used prior to your treatment to maximise your comfort. Small, gentle and precise injections are delivered to the keloid scars. The procedure is tolerable for most individuals.

Side effects of steroids injections include:

  • Skin or underlying Fat Thinning
  • Skin blood vessels becoming more apparent
  • Pigmentation changes to the skin.
  • Skin denting inwards (may be permanent)

You will only feel a mild snapping or rubber band like sensation on the skin.

After your treatment, you will experience some swelling, redness and itchiness on the treated area. This will subside over the coming days. Within weeks, you should see an improvement in size and colour of your keloids.

Recovery time varies depending on the size of the keloid and the method of removal. Patients may experience some swelling, redness, and discomfort at the site, which typically subsides within a few days to weeks.

There is a risk of keloid recurrence, particularly if the underlying cause of keloid formation is not addressed. Following proper aftercare instructions and sometimes additional treatments, such as steroid injections or pressure therapy, can help reduce the risk of recurrence.

The effectiveness of keloid removal depends on various factors, including the size and location of the keloid, the chosen treatment method, and individual healing responses. While keloid removal can improve the appearance and symptoms of keloids, complete removal may not always be achievable.

While many individuals can undergo keloid removal, not everyone may be suitable candidates. Factors such as the size and location of the keloid, overall health, and medical history may influence candidacy. A healthcare provider can assess eligibility for treatment.

Dr Moses Ng dermatologist

keloid scars

A lot of the patients I see have keloid scarring, mostly as a result of acne. Once the acne has subsided, the disproportionate healing response can lead to keloid formation. As keloid has a complex pathophysiological process, I prefer to use a combination approach that tackles the multiple factors causing keloid in the first place.

schedule a consultation for keloid scar removal treatment in singapore

Although keloids are known to be challenging to treat, Dr. Ng makes it his mission to help his patients reach his/her goals with the best keloid treatment that is designed for you. Contact us today to schedule a consultation, so that Dr. Ng can develop a personalized treatment approach for resolving your skin concerns and helping you to achieve long-term improvements in the health and appearance of your skin.

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  1. Hayashi T, Furukawa H, Oyama A, et al. A new uniform protocol of combined corticosteroid injections and ointment application reduces recurrence rates after surgical keloid/hypertrophic scar excision. Dermatol Surg. 2012 Jun. 38(6):893-7.
  2. Robinson AJ, Khadim MF, Khan K. Keloid scars and treatment with Botulinum Toxin Type A: the Belfast experience. J Plast Reconstr Aesthet Surg. 2013 Mar. 66(3):439-40.
  3. Zhibo X, Miaobo Z. Intralesional botulinum toxin type A injection as a new treatment measure for keloids. Plast Reconstr Surg. 2009 Nov. 124(5):275e-7e.
  4. Alster T. Laser scar revision: comparison study of 585-nm pulsed dye laser with and without intralesional corticosteroids. Dermatol Surg. 2003 Jan. 29(1):25-9.
  5. Limmer, E.E., Glass, D.A. A Review of Current Keloid Management: Mainstay Monotherapies and Emerging Approaches. Dermatol Ther (Heidelb) 10, 931–948 (2020). 
  6. Shaarawy E, Hegazy RA and Abdel Hay RM. Intralesional botulinum toxin type A equally effective and better tolerated than intralesional steroid in the treatment of keloids: A randomized controlled trial. J Cosmet Dermatol 2015; 14: 161–166.