Keloid treatment
keloid scar · intralesional steroid · triamcinolone and 5-fluorouracil · keloid excision and radiotherapy
Keloids are over-represented in Asian and African skin and under-served by advertising, which prefers problems a single device can claim. The common story online is a keloid that was cut out and came back larger.
Search interest: about 150 searches a month in Singapore for “keloid treatment singapore” (Ahrefs, October 2026).
Inject before you cut, and never cut alone; the scar that grows back larger is the one someone removed in one step.
Reviewed against the Aesthetics International standard. Category: Conditions.
What works for keloids?
Established. Inject before you cut, and never cut alone; the scar that grows back larger is the one someone removed in one step. A 2023 evidence-based systematic review and a 2025 network meta-analysis of intralesional therapies agree that combination treatment outperforms any single agent: triamcinolone with 5-fluorouracil produces more flattening and less recurrence than triamcinolone alone.
- Verdict
- Established Long clinical track record. Results depend on selection and technique more than on the device.
- Evidence base
- 5 PubMed-indexed studies cited below, including systematic reviews, meta-analyses.
- Suits
- Established keloids that itch, hurt or distort; earlobe keloids suited to excision with adjuvant treatment; people prepared for a course of injections and maintenance rather than a single procedure.
- Not for
- Excision alone; aggressive ablative laser alone; anyone expecting removal without recurrence risk; piercing or elective surgery in keloid-prone sites without a prevention plan.
- In Singapore
- Keloids are common in Singapore's population and are treated by dermatologists, plastic surgeons and aesthetic doctors; intralesional therapy is a clinic procedure, and post-excision radiotherapy is delivered in hospital radiation oncology units.
- Category
- Conditions · about 150 searches a month in Singapore for “keloid treatment singapore”
- Reviewed
- 6 October 2026 by Aesthetics International. Revised as evidence and regulation change.
What it is
A keloid is a scar that grows beyond the boundary of the original wound and does not regress — on the earlobe after piercing, the chest after acne, the shoulder after vaccination or surgery. It is an overgrowth of collagen driven by a prolonged healing response, with a strong genetic tendency. Treatment aims to flatten, soften and shrink it and to stop it recurring; cure is not a word the literature uses.
How it works
Injections of corticosteroid (triamcinolone) into the keloid, often combined with 5-fluorouracil, reduce collagen production and inflammation; repeated every four to six weeks. Pulsed dye and fractional lasers improve colour and texture and help drugs penetrate; cryotherapy shrinks smaller lesions; silicone sheets and pressure help maintain. Surgical excision alone recurs in most cases, so it is combined with injections or with low-dose radiotherapy within days of surgery.
What the evidence says
A 2023 evidence-based systematic review and a 2025 network meta-analysis of intralesional therapies agree that combination treatment outperforms any single agent: triamcinolone with 5-fluorouracil produces more flattening and less recurrence than triamcinolone alone. A 2022 Cochrane review found low-certainty evidence for lasers as part of treatment. For excision, a 2021 meta-analysis found adjuvant radiotherapy within the first days after surgery substantially lowers recurrence, and a 2023 systematic review of controlled studies supports excision plus adjuvant therapy over excision alone.
What people are saying
Paraphrased from public discussion on TikTok, Instagram, Reddit and in the press. Not testimonials, and not about any one clinic. Reported in: reddit.com, reddit.com.
What the studies show
- systematic review
Combination therapy — intralesional corticosteroid with 5-fluorouracil, or surgery with adjuvant radiotherapy or injections — showed better efficacy and lower recurrence than monotherapy across recent studies.
Keloid treatments: an evidence-based systematic review of recent advances. — Syst Rev, 2023. PMID 36918908.
- network meta-analysis
Triamcinolone combined with 5-fluorouracil ranked above triamcinolone alone and other single agents for scar improvement and recurrence risk.
Comparative Efficacy and Recurrence Risk of Intralesional Therapies for Hypertrophic Scars and Keloids: A Network Meta-Analysis. — Aesthet Surg J, 2026. PMID 40972598.
- systematic review
Evidence for lasers in keloid and hypertrophic scars was of low to very low certainty; lasers may improve scar appearance, particularly combined with other treatments.
Laser therapy for treating hypertrophic and keloid scars. — Cochrane Database Syst Rev, 2022. PMID 36161591.
- meta-analysis
Adjuvant radiotherapy delivered within the first days after keloid excision was associated with substantially lower recurrence than later or no radiotherapy.
Timing of Adjuvant Radiotherapy After Keloid Excision: A Systematic Review and Meta-Analysis. — Dermatol Surg, 2021. PMID 34417379.
- systematic review
Excision followed by adjuvant injection or radiotherapy reduced recurrence compared with excision alone in prospective controlled studies.
Excision and adjuvant treatment to prevent keloid recurrence — a systematic review of prospective, clinical, controlled studies. — J Plast Surg Hand Surg, 2023. PMID 35848929.
Studies are selected for relevance and quality, not for agreement with the verdict; PubMed records are linked so the reader can check them.
Who it suits
Suits
Established keloids that itch, hurt or distort; earlobe keloids suited to excision with adjuvant treatment; people prepared for a course of injections and maintenance rather than a single procedure.
Not for
Excision alone; aggressive ablative laser alone; anyone expecting removal without recurrence risk; piercing or elective surgery in keloid-prone sites without a prevention plan.
Alternatives
The two reviewed treatments most often weighed against Keloid treatment, on the same standard.
| Keloid treatment | 'Ozempic face' | GLP-1 medicines for weight loss | |
|---|---|---|---|
| Verdict | Established | Established | Established |
| What it is | A keloid is a scar that grows beyond the boundary of the original wound and does not regress — on the earlobe after piercing, the chest after acne, the shoulder after vaccination or surgery. | Not a treatment but a consequence. | GLP-1 receptor agonists are prescription medicines, given as a weekly or daily injection, that mimic a gut hormone to slow stomach emptying and reduce appetite. |
| Evidence base | 5 PubMed-indexed studies cited below, including systematic reviews, meta-analyses. | 3 PubMed-indexed studies cited below, including systematic reviews. | 5 PubMed-indexed studies cited below, including systematic reviews, randomised trials. |
| Suits | Established keloids that itch, hurt or distort; earlobe keloids suited to excision with adjuvant treatment; people prepared for a course of injections and maintenance rather than a single procedure. | Anyone whose weight loss has outpaced their face. Assessment should map which layers have changed before anything is injected. | Adults who meet the medical criteria for weight management treatment, prescribed and monitored by a doctor, who understand that the medicine is continued rather than completed and that eating and activity still matter. |
| In one line | Inject before you cut, and never cut alone; the scar that grows back larger is the one someone removed in one step. | A real condition with an established approach: volume first where it is genuinely missing, lift where tissue has descended, and restraint throughout. | The weight loss is real and well measured; so is the regain when it stops. The face it leaves behind is a separate decision, better made once the weight has settled. |
Risks
Injection pain; skin thinning, pallor and visible vessels at the site; hyperpigmentation with lasers in darker skin; recurrence after any treatment; the small long-term risks of radiotherapy, weighed against recurrence.
In Singapore
Keloids are common in Singapore's population and are treated by dermatologists, plastic surgeons and aesthetic doctors; intralesional therapy is a clinic procedure, and post-excision radiotherapy is delivered in hospital radiation oncology units. Scar protocols published here address atrophic scars; keloids need the drugs-and-adjuvants approach described above, and a keloid-prone history should be declared before any procedure.
“Inject before you cut, and never cut alone; the scar that grows back larger is the one someone removed in one step.”
Vetted protocols on the same problem
Questions
Can keloids be removed?
What is the most effective keloid treatment?
Can laser remove a keloid?
How many injections does a keloid need?
Does radiotherapy for keloids cause cancer?
Will I get keloids from aesthetic treatments?
Cite this review
Aesthetics International (2026). Keloid treatment: does it work? Evidence, risks and verdict. https://aesthetics-international.org/treatments/keloid-treatment/ (reviewed 6 October 2026).
Editorial, unpaid and independent of any manufacturer. Verdict: Established. See what works and what doesn't across all 153 reviews. Spotted an error or a newer study? Suggest a correction — changes are logged on the corrections page. Terms are defined in the glossary.
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