Keloid Removal in the UK: A Consultant’s Guide

What a Keloid Is (and Isn’t)

A keloid is an overgrowth of scar tissue — excess collagen laid down after the skin heals — that extends past the boundaries of the original injury, stays raised, and can be itchy, tender or cosmetically distressing. The crucial distinction is from a hypertrophic scar, which is also raised but stays within the wound’s borders and often fades over time. Keloids don’t respect the wound edge and rarely regress without treatment. They commonly follow ear piercings, acne, surgery, burns or even minor cuts, and form most often on the earlobes, chest, shoulders and upper back. Our guide to keloid causes and prevention goes deeper on why they form and who’s prone.

Why Keloids Are Hard to Treat

Keloids are notorious for recurrence. Simple surgical removal alone has a high rate of coming back — often worse than before — because the act of cutting is itself another wound that can trigger fresh keloid formation. That’s the single most important thing to understand before treatment: success isn’t about removing the lump once, it’s about removing it and then suppressing the tissue’s tendency to over-heal. A genetic predisposition (keloids are more common in people with darker skin tones and a family history) means the tendency doesn’t disappear — but it can be managed well. We explain this fully in why keloids keep coming back.

Treatment Options, Honestly Compared

• Steroid (corticosteroid) injections: a mainstay — they flatten and soften keloids and ease itch, and are often the first-line treatment, sometimes used without surgery for smaller keloids.
• Intralesional excision + steroid protocol: the most effective approach for larger keloids — removing the keloid from within its own borders (sparing healthy skin) then injecting steroid on a planned schedule to hold recurrence down.
• Silicone gel / sheeting: evidence-based aftercare that helps flatten and settle the scar during healing.
• Pressure therapy: useful for ear keloids (pressure earrings) after removal.
• Laser: can improve redness and texture as an adjunct, not a standalone cure.

Anything promising a guaranteed, one-and-done keloid “cure” should be treated with scepticism — the honest goal is a flat, settled scar with the lowest realistic chance of return.

Our Combination Protocol

At London Skin Clinic, keloid removal is a planned combination treatment, performed under local anaesthetic by a consultant plastic surgeon:

1. Intralesional excision — the keloid is removed from within its borders, without cutting away healthy surrounding skin, and a steroid is injected the same day.
2. Second steroid injection at ~2 weeks, when the stitches are removed.
3. Final steroid injection at ~6 weeks.
4. Silicone gel (e.g. Kelo-cote) from around 3–4 weeks to support the healing scar.

It’s this surgery-plus-suppression sequence — not surgery alone — that gives the best chance of a lasting, flat result.

The more common problem is not over-treatment, it is under-treatment. That is worth saying because it runs against the pattern for most benign lesions, where the honest advice is usually to leave well alone. Keloids are the exception.

I think many keloids are under-treated, in the sense that patients are offered either reassurance or steroid injections alone, when they often benefit most from a planned combination of treatments including surgery. This is probably because surgeons are reluctant to risk making things worse, as they have little experience with keloids.

Mr Onur Gilleard, Consultant Plastic Surgeon

The reluctance is understandable — a keloid that is cut out badly comes back larger, and that is a real risk in inexperienced hands. But the answer to that is a planned combination, not avoidance. Around 300 keloids a year are treated here, across roughly 200 patients, and surgery is never performed without adjuvant steroid injection alongside it. Recurrence after that combination runs at about 5%.

Ear Keloids

Keloids on the earlobe — usually after piercings — are one of the most common types we treat, and they respond well to excision plus the steroid protocol, often with a pressure earring afterwards to discourage regrowth. See our dedicated guide to ear keloid removal and preventing recurrence.

Recovery and Aftercare

Removal is a minor, walk-in procedure under local anaesthetic. Afterwards: keep the area clean and protected, use sunscreen on the healing scar for at least a couple of weeks, and avoid pressure or friction over it. Stitches come out at around two weeks (with the second steroid injection), and there’s a follow-up at six weeks for the final injection. Avoid strenuous exercise for about two weeks for torso keloids, or a few days for face and ear sites. The scar then continues to settle over the following months.

The Treatment Timeline

Keloid treatment is a journey of a few months, not a single appointment — and knowing the shape of it helps set realistic expectations:

• Day of removal: intralesional excision under local anaesthetic, plus the first steroid injection.
• ~2 weeks: stitches removed and the second steroid injection; silicone gel introduced from around three to four weeks.
• ~6 weeks: the final steroid injection of the planned course.
• Following months: the scar continues to flatten, soften and fade, with any early sign of return treated promptly.

It’s this structured follow-through — rather than the day of surgery alone — that determines the long-term result, which is why keeping each appointment matters.

What It Costs

• Initial consultation: £100
• Keloid scar removal: from £400
• Larger keloid removal: £550
• Each additional keloid (same visit): £250

The steroid-injection protocol and silicone aftercare are part of the planned treatment; your exact plan and cost are confirmed at consultation. See the keloid scar removal procedure page or book a consultation.

Frequently Asked Questions

Can a keloid be removed permanently?

It can be removed and kept flat for the long term, but no honest clinician promises a guaranteed permanent cure — keloids can recur because the underlying tendency is genetic. Combining excision with a steroid protocol and silicone aftercare gives the best chance of a lasting result.

Why not just cut the keloid out?

Because surgery alone has a high recurrence rate — the new incision can itself trigger fresh keloid. That’s why effective treatment pairs removal with steroid injections and silicone to suppress regrowth, rather than relying on excision by itself.

Do I always need surgery, or can injections alone work?

Smaller keloids can sometimes be managed with steroid injections alone, which flatten and soften them. Larger or stubborn keloids usually do better with intralesional excision plus the injection protocol. A consultation decides which suits you.

Is keloid removal painful?

The procedure is done under local anaesthetic, so the area is numb — you feel pressure, not pain. Steroid injections can sting briefly. Mild soreness afterwards settles with simple painkillers.

Are keloids more common in darker skin?

Yes — keloids are more common in people with darker skin tones and those with a family history. This doesn’t prevent treatment, but it does mean prevention and recurrence-suppression are central to the plan.

How are ear keloids treated?

Ear (earlobe) keloids, usually from piercings, respond well to excision plus the steroid protocol, often with a pressure earring afterwards to discourage regrowth. They’re one of the most common keloids we treat.