Reviewed by Dr Salinda Johnson MD FSCD
Keloid scars are not “just a raised scar”. They are an overgrowth of scar tissue that can keep expanding beyond the original injury. They itch, tighten, catch on clothing and change how people dress, wear jewellery and feel in photographs.
The London Cosmetic Clinic on Harley Street is known for keloid and hypertrophic scar work as well as aesthetics. Since 2012 the medical team has treated more than 100,000 patients under Medical Director Dr Salinda Johnson. This article explains how we think about keloids — and why generic “scar removal” marketing is usually the wrong frame.
Keloid vs hypertrophic scar
A hypertrophic scar is raised and red but stays within the border of the original wound. It often improves slowly with time, silicone and pressure.
A keloid grows beyond the wound edge. It can appear months after an ear piercing, acne spot, vaccination, burn, C-section or surgical incision. It does not reliably fade on its own.
Getting the diagnosis right changes the plan. Cutting out a keloid as if it were a mole, with no adjuvant treatment, is a classic way to make a bigger keloid.
Why keloids form
Risk is higher in people with darker skin phototypes, a family history of keloids, and wounds on the chest, shoulders, jawline and earlobes. Tension on a healing wound, infection and repeated trauma (including picking) all add fuel.
You did not cause a keloid by “not using Bio-Oil”. That myth wastes time and delays proper care.
Why home remedies and one-off steroid shots fail
Silicone sheets and taping have a place in early hypertrophic scars. They rarely flatten an established keloid on the chest or ear.
A single steroid injection can soften a small lesion temporarily. Keloid care is a protocol: repeated, measured treatments, photographs, and a plan for what happens if the scar wakes up again. Learn more about our keloid clinic approach and research support.
Evidence-based options we discuss
Treatment is layered, not theatrical:
- Intralesional corticosteroid, sometimes combined with 5-fluorouracil in selected cases
- Vascular laser such as Vbeam to reduce redness and itch in suitable scars
- Surgery only when the benefit outweighs recurrence risk — and almost always with adjuvant treatment afterwards
- Pressure, clips (especially ears), silicone and strict aftercare
- Medical aftercare for acne-related keloids so new spots do not seed new scars
No responsible specialist promises “gone forever” after one visit. The goal is flatter, paler, quieter, and less likely to rebound.
Ear piercing, chest and shoulder keloids
Earlobe keloids after piercing are among the most common requests we see. Chest and shoulder keloids are often more stubborn because of skin tension. Each site needs a different mix of injection, laser, surgery and pressure.
If you are planning further piercings or elective surgery and you keloid, say so before the procedure. Prevention is easier than salvage.
Skin of colour
Keloids are not a cosmetic footnote in deeper skin tones. They are a medical and psychosocial issue. Treatment must respect pigment risk: the wrong laser or an aggressive peel can add post-inflammatory hyperpigmentation on top of the scar. That is why doctor-led assessment matters.
When not to operate
Active, rapidly growing keloids, patients who cannot commit to follow-up, and anyone expecting a completely invisible result from surgery alone are poor operative candidates. We would rather decline an operation than create a larger problem.
How to prepare for a Harley Street keloid consultation
Bring a timeline (when the injury happened, what has already been injected or excised), a list of medicines, and photos if the scar changes through the month. Wear clothing that lets us see the whole lesion and nearby skin. Ask about recurrence rates for your site, not a global average.
FAQs
Can a keloid be removed completely?
It can often be flattened and calmed. Complete, permanent disappearance with zero recurrence risk is not an honest guarantee.
Is keloid treatment painful?
Injections sting. We use techniques to make them tolerable. Laser sensation is brief. Surgery is planned with appropriate anaesthesia.
Will the NHS treat my keloid?
Access varies by area and severity. Many patients come privately because they want a dedicated scar protocol and continuity with the same doctors.
Can I treat a keloid while pregnant?
Many options are deferred. Tell us if you are pregnant or planning pregnancy.
Are keloids cancer?
Keloids are benign. They can still be painful, itchy and functionally limiting, which is why treatment is justified.
Start with a proper scar diagnosis
If a raised scar is growing, itching or embarrassing you out of earrings or open-neck shirts, book a consultation. We will tell you whether it is a keloid, what is worth doing first, and what is not. Book a consultation
