Keloid Grew Back After Injections? Here's Why

A keloid can grow back after injections because the shots soften and flatten the scar you can see, but they don't switch off its habit of making more scar tissue. Cut out on its own, a keloid almost always returns. Lowering the odds usually means combining treatments over several months: injections, pressure and silicone.

So a flat keloid isn't a finished keloid. In this article, we'll cover why keloids regrow, who tends to get them, how injections are spaced, what removal can and can't do, what to keep doing once the scar is flat and how treatment fits a trip to Seoul.

Quick summary

• A keloid that's only cut out almost always grows back, so injections, pressure and silicone are usually combined.
• Injections: steroid shots come as a series about 4 weeks apart, and itching and pain tend to ease first.
• When radiation was added after removal, keloids came back in 14% to 18% of cases.
• Silicone sheets: worn 12 to 24 hours a day for at least 8 to 12 weeks to expect a benefit.

Why Do Keloids Grow Back After Injections?

Keloids keep producing scar tissue after the wound has closed, and that's the part injections can't fully stop. Unlike most scars, a keloid spreads past the edges of the original wound. It can keep growing slowly for months or even years.

Steroid shots work on the scar that's already there. They make it softer and flatter, and they usually calm the itching. The tissue that remains, though, can still start building up again once the shots stop. That's why a keloid that looked settled can rise again a few months later.

This doesn't mean the injections failed. It means the plan needs a second half: what you do after the scar flattens. Keep in mind that how quickly a keloid returns, if it does, differs from person to person.

Keloid vs. Hypertrophic Scar: Is Your Skin Keloid-Prone?

Keloid-prone skin often runs in families. Between 33% and 50% of people with keloids have a relative who has them too. Keloids are also more common in people with darker skin, and they tend to form on the upper chest, shoulders, ears and neck.

If that sounds like you, even a small new wound in the same area can set off another keloid. A piercing or a surgical cut counts as a wound, too.

Telling a keloid apart from a hypertrophic scar (a thick, raised scar that stays within the wound) helps you know what to expect. A hypertrophic scar usually appears within 1 to 2 months of the injury and doesn't spread beyond the wound's borders. A keloid can show up months later and slowly grows past those borders. Both can feel raised and firm, so timing and edges are the clues to watch.

How Many Steroid Injections Do Keloids Need, and How Far Apart?

Keloid injections are given as a series, usually about 4 weeks apart, rather than as a one-time fix. After the first shot, itching and pain tend to ease before the scar itself changes much. With later shots, the keloid gradually feels softer and sits lower.

In a trial that randomly split 60 people with keloids into two groups, the steroid group had 4 injections spaced 4 weeks apart. That's a useful picture of a typical course, though your own number of shots depends on the size and thickness of the scar.

At each visit, I press on the scar to check its height and firmness, then decide the timing and amount of the next shot. A series softens and flattens a keloid; it isn't a promise that the scar disappears. Individual results vary, and many people still need pressure or silicone afterward.

Keloid Injection Side Effects: What's Normal and When to Call?

Thinner skin and lighter patches at the injection site are common with repeated steroid shots. In the steroid group of that 60-person trial, 80% developed lighter skin at the site (hypopigmentation), and 73.3% had skin thinning (atrophy). These changes are a big part of why the dose and spacing get adjusted along the way.

Some changes shouldn't wait for your next scheduled shot. Let your provider know right away if you notice any of these:

• The injection site looks sunken, or the skin there looks thin
• A white or light patch keeps getting larger
• Fine red blood vessels start showing through the skin, like thin threads

Pus or warmth at the injection site is a different matter. If you notice either, seek medical care right away rather than waiting for your next appointment.

Can You Have a Keloid Removed Without It Coming Back?

You can have a keloid removed, but removal is paired with at least one other treatment to lower the odds of regrowth. Radiation is one of those add-ons.

An analysis that pooled 106 studies and 10,745 keloids looked at radiation given after removal. The keloid came back in 14% to 18% of cases across radiation types, with no clear difference between them. Complications were also reported in 9% to 18%, so it's a trade-off to weigh rather than a sure thing.

Steroid shots are another add-on. Shots given after surgery were linked to fewer recurrences than shots given before or during surgery. That comparison pooled records from different clinics, though, so the evidence isn't strong. If removal is on the table for you, ask which add-on treatment would follow and for how long. How well it holds up depends on the site and your skin.

What Should You Keep Doing After a Keloid Flattens?

Once a keloid has flattened, silicone sheets or pressure usually continue for several more months. Silicone sheets need to be worn 12 to 24 hours a day for at least 8 to 12 weeks, and sometimes longer. Never put them on scabs or on a wound that hasn't closed.

Silicone can also be tried first on a small, new keloid. Some people apply a sheet as soon as a new wound on the ear or body has healed, to help keep a keloid from forming. If you're keloid-prone, skipping new piercings and avoidable skin injuries is part of keeping one from coming back.

That said, everyone's skin is different, and how much silicone or pressure helps varies from person to person. Wearing it for the hours it needs is the hard part, so it's worth choosing a sheet you can comfortably keep on for most of the day.

Fitting Keloid Treatment Into Your Travel Schedule

Unless you've had sedation that day, there's no need to postpone your flight home after keloid treatment.

It also helps to know what one visit can and can't do. Some treatments, such as fillers, change your shape the same day. Most others work gradually, bringing your skin closer to how it used to be rather than changing it all at once. Keloid injections belong to the gradual group and come as a series, so a single visit doesn't replace the full course.

Once you're home, you can contact us with photos of the scar if you're unsure whether it's starting to grow again. If it suddenly gets bigger or looks infected, see a local doctor first rather than waiting for a reply.

The Bottom Line: What to Ask Before Your Last Injection

Before your series ends, settle what happens once the keloid is flat: silicone or pressure, and for how many weeks. A good first question is, "After my last injection, how long should I keep using silicone or pressure?" Write down the date of your last shot and take a photo of the scar that day, so you have something to compare against if it seems to rise later.

If you'd like a doctor to look at a keloid that's come back, you can reach Beautystone, a clinic in Seoul's Hapjeong area, through the consult button on this page. In your first message, include where the keloid is, how long you've had it and which treatments you've already tried.

Sources

• How keloids are treated and how regrowth is reduced (American Academy of Dermatology)
• Why keloids form and who tends to get them (American Academy of Dermatology)
• Keloids vs. hypertrophic scars, and how long to wear silicone sheets (DermNet)
• How often keloids came back when radiation was added after removal (J Plast Reconstr Aesthet Surg, 2026)
• Recurrence by timing of steroid injections around keloid surgery (Aesthetic Plast Surg, 2024)
• 60 people with keloids given 4 injections, 4 weeks apart (Wound Repair Regen, 2024)

Frequently Asked Questions

Q. Will keloid injections make the scar go away completely?

A. Keloid injections usually don't make the scar go away completely. They mainly ease itching and pain and make the keloid softer and flatter. Because shots alone often aren't the end of treatment, pressure or silicone is usually planned alongside them.

Q. How do I keep an earlobe keloid from coming back after removal?

A. An earlobe keloid that's been removed is often followed by a pressure earring, worn 12 to 20 hours a day for several months. Re-piercing the same spot can set off another keloid, so it's best avoided.

Q. Is cryotherapy an option for keloids?

A. Cryotherapy (freezing the scar) tends to suit small keloids. Results were better when people had 3 or more treatments. On darker skin, it can leave permanent light spots, so it may not be recommended.

Q. Do lasers work on keloids?

A. Laser treatment can be used on keloids to lower their height and fade their redness. Your provider looks at the scar's color and thickness first to decide whether a laser fits and where it comes in the plan.

Q. Why does my keloid itch and hurt?

A. A keloid can itch or hurt while it's growing. Once it stops growing, the pain usually goes away, although some people have pain that lasts. If a keloid suddenly gets bigger, have it checked.

Q. Do steroid injections leave light spots on darker skin?

A. On darker skin, keloid injections can leave light spots at the injection site. Mention this concern before your first shot so the dose and spacing can be planned with it in mind.

Q. Can I get other skin procedures if I'm keloid-prone?

A. If you're keloid-prone, tell your provider before any procedure that breaks the skin. A keloid can appear months after an injury, so the treatment area is worth weighing carefully, especially on the upper chest, shoulders, ears and neck.

Q. When can I start using silicone sheets on a keloid?

A. Silicone sheets go on once the wound has fully closed and any scabs have come off. After keloid surgery, they're also used to help keep the keloid from coming back.