Keloid Scar Treatment Birmingham
Specialist assessment and treatment for keloid and hypertrophic scars
At Midland Skin we offer Keloid Scar Treatment for patients in Birmingham, Solihull, Coventry, Wolverhampton, Worcester and the Midlands.
Quick Facts about keloid scar treatment
Best for
Raised, itchy or growing scars
Appointment
Initial scar assessment
Treatment
Injections, laser, cryotherapy, scar therapy
Sessions
Course over several months
Provider
Consultant
Price
See below
What are keloid scars?
A keloid is an overgrown, raised scar that extends beyond the original wound. Unlike typical scars, keloids can continue to enlarge over months or even years.
Keloid scars can cause pain and itching.
They often feel firm or rubbery and may appear shiny pink-purple on lighter skin, or dark brown on darker skin.
Common sites include the chest, shoulders, jawline, and ear lobes.
Why do keloid scars form?
Keloids may occur after trauma or burn, surgery, ear piercing, acne or other injury to the skin. Sometimes keloid can appear spontaneously.
Several factors contribute to keloid formation:
- Abnormal healing pathways. Overactive fibroblasts produce excessive collagen causing scars to expand.
- Genetics and skin type. Keloids are more common in individuals of Black or Asian origin. Keloid scars affect approximately 0.1–0.4 % of the general UK population, but the incidence can be much higher, up to 16 %, in individuals with darker skin types.
- Mechanical tension and trauma: Scars in high-tension areas, or wounds complicated by infection or delayed healing, are more likely to form keloids.
Where keloids occur, and how well they respond
Keloids can form anywhere, but some sites are far more prone than others — and the site also affects how well a keloid responds to treatment. Much of this comes down to skin tension: keloids in areas under constant mechanical tension are harder to control and more likely to return.
Keloid scars can be improved and their symptoms controlled, but they cannot usually be removed completely, and treatment is a course rather than a one-off procedure.
Ear lobes. Usually follow piercing. The skin here is under low tension, and ear-lobe keloids respond better than at any other site, particularly when surgery is combined with compression and injections. Recurrence after treatment is lowest here.
Jawline, cheeks and beard area. Often follow acne or shaving. Controlling the underlying acne or folliculitis is usually as important as treating the scar itself, and response is often partial.
Nape of the neck and back of the scalp. Firm bumps and scarring here often follow shaving or ongoing inflammation in the hair follicles, and the underlying skin problem usually needs treating alongside the scar.
Chest and breastbone. The most difficult site to treat. The skin is under constant tension from breathing and movement, response is slower, and recurrence is more likely than elsewhere. Treatment usually needs to be combined and continued over a longer period, and the realistic aim is often symptom relief and flattening rather than removal.
Shoulders and upper back. Behave similarly to the chest — high tension, slower response, and a greater chance of recurrence.
Site, alongside how big the lesions are, is one of the main things assessed at your consultation. It shapes both which treatments are recommended and what can realistically be achieved — ear-lobe keloids are the most treatable, while the chest, shoulders, upper back and jawline are all more difficult.
Is keloid treatment right for me?
Keloid scars rarely settle on their own, and over-the-counter products alone are often not enough. A dermatology assessment is worthwhile when:
- The scar is raised, firm or still growing – particularly if it now extends beyond the original wound
- The scar itches, stings or is painful – symptoms often respond to treatment even when the scar does not flatten completely
- Ear-lobe keloids after piercing – these are common and are managed differently to keloids elsewhere
- The keloid has returned after previous surgery or treatment – recurrent keloids need a combination approach
- Silicone, pressure or pharmacy products have not helped – prescription and procedural treatments may be appropriate
- The scar affects appearance, clothing or confidence
- You are not certain the lump is a keloid – hypertrophic scars and other raised lesions can look similar
Keloid or hypertrophic scar?
Hypertrophic scars are raised, red marks that stay within the original wound margins. Keloids, by contrast, grow into the surrounding normal skin and can keep enlarging for months or years. Keloid scars are usually firmer, more conspicuous, and may be itchy or sore. Hypertrophic scars often flatten with time, whereas keloids rarely improve without active treatment. We treat both keloid and hypertrophic scars.
What does the initial scar assessment include?
The initial scar assessment is with a consultant and is where your treatment plan is made. It includes:
- Discussion of your concerns – and any previous treatment and how the scar responded
- Examination and clinical photography – of the keloid(s), giving a baseline to measure response against
- Advice on investigations – whether anything further, such as a biopsy or blood tests, is needed
- Treatment options – whether the keloid can be treated, the options, likely outcomes, downtime, aftercare and cost
- Referral for scar therapy – if the consultant thinks supportive scar care (see below) would help you
- A written care plan – summarising the recommendations and pricing
- A copy of the clinic note – sent to you and your GP
Not every keloid can be treated, particularly where previous treatment has not worked, and the consultant will be honest with you about whether treatment is worthwhile in your case. There is no obligation to proceed with treatment after the assessment.
Lily Hale
Keloid Scar Treatment at Midland Skin
There is no cure for keloid scars, and no licensed treatment. Treatment aims to flatten and soften the scar and relieve symptoms such as itch and discomfort. Most people need a course of treatment over months, responses vary considerably between individuals, and keloids can recur even after a good result.
The most effective results are usually achieved by combining treatments tailored to your scar’s size, location, and behaviour. Which treatments are recommended depends on your assessment — not every treatment listed below is appropriate for every keloid.
Treatment at Midland Skin falls into two groups, and a plan often combines both:
Consultant-led treatment. Injections, lasers and cryotherapy, and in selected cases surgery.
Supportive scar care. Silicone therapy, compression garments, scar taping, massage and skin camouflage, provided by our experienced scar therapist (who is not a doctor), alongside or sometimes instead of consultant-led treatment.
Which of these might be suitable for you is decided by the consultant, in discussion with you, at your initial scar assessment.
First-line treatments
Intralesional corticosteroid injection. Steroid injected directly into the keloid, usually every 4–6 weeks. This is the most established treatment and is often the starting point, particularly where itch and discomfort are the main problems.
5-Fluorouracil (5-FU) with steroid injection. Dual therapy injection into the keloid can improve flattening and pigmentation. 5-FU is a chemotherapy medication.
Vascular laser, with or without injection. Helps reduce redness and can improve response to injection. Usually combined with steroid or 5-FU rather than used alone.
Cryotherapy. Freezing of the keloid with liquid nitrogen. Cryotherapy can improve flattening compared with injection alone. Cryotherapy can cause temporary blistering, and may cause lightening of the treated skin, which is more noticeable and more likely to persist in darker skin types. This is discussed carefully before treatment.
Second-line and combination treatments
Combination laser therapy. Vascular and ablative fractional laser, with 5-FU or steroid, for more resistant keloids. Treatment is repeated every 4–8 weeks. Botulinum toxin and hyaluronidase may also be added to the mixture.
Other injectable medicines. In a small number of resistant keloids, other injectable medicines may be added or substituted. These are only used where standard injections have not worked, and are discussed individually.
Surgical excision with adjuvant treatment. Surgery alone is not usually recommended, as recurrence rates are high, often with the keloid returning larger than before. In certain cases, such as ear-lobe keloids, surgery may be considered, but always with additional treatments like compression with a custom ear splint, steroid or chemotherapy injections or laser.
Surgery with post-operative radiotherapy (within 24–72 hours) is another option, although we do not offer radiotherapy at Midland Skin.
Supportive scar care
Supportive scar care is provided by our scar therapist, by referral from your consultant after your initial scar assessment. It begins with a separate scar therapy assessment, and can run alongside injections or laser, or on its own where consultant-led treatment is not the right option.
Silicone gel or sheeting. Worn at least 12 hours daily for at least 3 months. Supports other treatments rather than replacing them.
Compression therapy. Such as custom made ear pressure splints, garments or with tension reducing tape.
Occlusion therapy. This can help soften keloids and reduce symptoms.
Scar massage. Your scar therapist shows you how to massage the scar at home to keep it supple.
Skin camouflage. Colour-matched cover creams to reduce the visibility of redness or dark marks, with advice on how to apply them.
Can keloid scars be removed?
Keloid scars cannot usually be removed completely. Cutting a keloid out on its own is not usually recommended, because it often comes back, sometimes larger than before.
Surgical removal can be considered for some keloids, particularly on the ear lobe, but always combined with other treatment such as a custom compression splint, steroid or 5-FU injections, or laser, to lower the chance of it returning.
What results can I realistically expect?
Keloids cannot usually be removed entirely. Treatment aims to flatten, soften, and fade the scar, while relieving symptoms such as itching and discomfort. Unfortunately, there is no guarantee a particular treatment will be effective or that the keloid will not recur after successful treatment.
Treatment responses vary between individuals, and a guarantee cannot be given. If first line treatments do not work you will be offered second line treatments.
Keloid treatment is a course rather than a single procedure. Most treatments are repeated at 4–6 week intervals over several months, and improvement is gradual. Symptoms such as itch and soreness often improve before any visible change in the scar.
Recurrence is common in keloid disease, and a scar that has flattened can thicken again. Continuing measures such as silicone, compression or occasional maintenance injections are often part of long-term control.
Treatment pathway
Initial scar assessment
Your doctor examines the keloids, takes clinical photographs, and reviews your symptoms, previous treatments and how the scar has behaved over time.
Treatment plan
Suitability for treatment is discussed, along with the options, likely outcomes, downtime, aftercare and cost. You receive a written care plan, and a copy of the clinic note is sent to you and your GP. If supportive scar care would help, you are referred for a scar therapy assessment. Further investigation, such as a biopsy, is only occasionally needed.
Treatment sessions
Most treatments are given as a course, usually repeated every 4–6 weeks. Treatment is not normally started at the initial assessment.
Review consultation
A review consultation is required to assess your response, compare against your baseline photographs, and decide whether treatment should be continued, changed or stopped. Many individuals require long term or intermittent treatment.
Your keloid appointments: FAQs
Who will assess and treat me?
You will be seen by a Consultant Dermatologist or Surgeon, who will assess your scars, agree a treatment plan with you, and carry out or supervise your treatment.
Will I have treatment at my first appointment?
The first appointment is an assessment. Your keloids are examined and photographed, and a written plan and costing are prepared for you. Treatment is normally arranged at a separate appointment once the plan has been agreed.
What is the scar therapy assessment?
If your consultant thinks supportive scar care would help, you are referred to our scar therapist for a scar therapy assessment. This is a separate appointment where silicone, compression, taping, massage or skin camouflage are planned for you. The scar therapist is not a doctor, and scar therapy is charged separately, with fees for any treatment advised at that assessment.
How many treatment sessions will I need?
This depends on the size, number and behaviour of your keloids. Most treatments are repeated every 4–6 weeks over several months, and your plan is reviewed as you go.
Will treatment hurt?
Injections into a keloid are uncomfortable but brief, and the scar is often tender for a day or two afterwards. Laser can feel like a hot or cold snap on the skin. Local or topical anaesthetic is used where appropriate.
Is there any downtime afterwards?
Most people return to normal activities the same day. Injections may cause temporary tenderness or bruising. Laser and cryotherapy can cause redness, crusting or blistering for a few days, and cryotherapy may lighten the treated skin. You will be given aftercare advice at each appointment.
I am having ear keloid surgical excision, and I have been told I need a custom made ear compression splint?
If you are having ear surgery for keloid removal, you will need a custom made ear splint that is worn for up to 24 hours a day for 12 months. A custom made splint is comfortable and painless to wear and reduces the risk of keloid scars recurring. You will be referred to a specialist centre in the West Midlands for a splint to be created bespoke to your ear.
What will the cost of treatment be?
Bespoke pricing is provided after a full assessment and depends on the number, size, and type of keloid and the treatment plan recommended. Different medications and laser treatments have different costs associated with them. The fees listed on this page are starting prices, given as an indication; the exact cost for your keloid, and the number of sessions likely to be needed, is confirmed after your initial scar assessment. The assessment fee is payable at booking and is not deducted from the cost of any treatment.
Do I need to send a photograph before booking?
We may ask for a clear photograph of the scar(s) before an appointment is arranged, so that our medical team can confirm it is something we treat. This is a suitability check only and does not lead to an assessment or a quote. Questions about treatment choice or pricing are answered at your initial scar assessment rather than by email.
What if the treatments you offer are not suitable for my keloid?
There are instances that certain keloid scars or patients may not be suitable for the treatments we offer and this will be advised at your consultation. Where feasible, onward referral for an opinion on treatments we do not offer will be discussed.
Why choose Midland Skin
Keloid scars respond best to combinations of treatments rather than any single one, and the right combination depends on the scar, its site and how it has behaved previously.
At Midland Skin, assessment is by a consultant, and injection, laser, cryotherapy and surgical options are available under one roof, together with supportive scar care from our scar therapist. That means the plan can be adjusted as we see how your scar responds, rather than being limited to one technique.
Keloid disease disproportionately affects people with darker skin, in whom pigment change after treatment is a genuine consideration. This is factored into which treatments are recommended and how they are delivered.
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Fees
Keloid scar assessment and treatment Show pricing
Book ConsultationInitial scar assessment
For keloid, hypertrophic, surgical, burn, self-harm or injury scars. Up to 25 minutes
Keloid or hypertrophic scar laser ± injection treatment
Keloid scar cryotherapy treatment
Review consultation
Standard, up to 20 minutes
Scar therapy and camouflage Show pricing
Book ConsultationInitial scar therapy assessment
With our scar therapist. By referral from your consultant only. Up to 45 minutes.
Initial skin camouflage assessment
Skin tone analysis and colour matching, product recommendations and application guidance, up to 60 mins.
References used for this article
- Walsh LA, Wu E, Pontes D, et al. Keloid treatments: an evidence-based systematic review of recent advances. Syst Rev. 2023;12:42. doi:10.1186/s13643-023-02192-7.
- Xu J, Yang E, Yang C, et al. Progress in the clinical treatment of keloids. Front Med. 2023;10:1284109. doi:10.3389/fmed.2023.1284109.
About the Author
This page has been written and/or medically reviewed by Dr Sajjad Rajpar, Consultant Dermatologist and Medical Director of Midland Skin, Birmingham.
Dr Rajpar is on the GMC Specialist Register in Dermatology and has over 20 years’ experience in clinical dermatology. He provides clinical oversight to ensure the information on this page is accurate, balanced and consistent with current dermatology practice.
Dr Sajjad Rajpar
Date last updated: 6th Oct 2026
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Expert, consultant led care in dermatology, skin surgery, eyelid surgery, lasers and aesthetics.
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