Reviewed by Dr Jessica Gunawan and Physician Kelvin Goh
Got an Unsightly Keloid Scar? Here’s What to Do About It
Published | 5 min read
A keloid scar can be an unsightly mark on your body and can even cause some discomfort. Find out if you might be more prone to it and how to treat it.
Keloid scars are a type of raised scars that cover an area bigger than the original wound. They can appear anywhere but are common in areas of the upper body, such as ear piercings.
People of Asian, Latino, and African descent are more likely to get keloids. Those with darker skin are 15% to 20% more likely to have scars that develop into keloids. Furthermore, if you have a family member with a keloid or you’re younger than 30, you’re more prone to get it too.
You may already have a keloid scar or wish to know what you can do if you ever develop one. Here are prevention and treatment tips, according to Western medicine and Traditional Chinese Medicine (TCM).
Understanding Keloid Scars
Scarring is a normal process of wound healing. Our immune system acts to seal the gap by growing scar tissue composed of the protein collagen. In people who don’t get keloids, the scarring is limited to the area of the wound. In keloid-prone individuals, skin scars are large, slow-expanding skin growths. It is very rare for a keloid scar to be successfully removed without recurrence.
This condition can cause distress if you feel that these scars are unsightly. In some cases, keloids can also cause discomfort, such as itchiness, tenderness, pain, or a burning feeling. A large keloid scar that develops over a joint can even reduce mobility in the joint.
Experts and researchers are still unsure why keloids develop in some people, but they believe it is related to an overproduction of collagen.
Keloid Scars and Treatment in TCM
According to TCM physician Kelvin Goh, extra scar tissue or keloids form due to Blood and Qi (vital energy) Stagnation. “Patients who tend to belong to Blood and Qi Stagnation body constitution will have a higher tendency of having keloids,” he shares.
“Regulated blood flow is needed to promote a healing environment for the wound. When blood and qi are not well-regulated in the wound area, it creates a stagnated environment. This will prevent good blood flow, and gradually there’ll be a build-up of Stagnation that causes keloids to form slowly,” he elaborates further.
TCM herbs and treatments such as acupuncture and gua sha are recommended by Physician Goh to improve keloids.
As keloids worsen gradually in some cases, herbal ingredients like Chinese yam (shan yao, 山药) and longan (long yan rou, 龙眼肉) can be consumed regularly to slow the condition. These can be consumed raw or cooked in soup.
Several herbs can invigorate qi and nourish blood, promote healthy blood flow, and prevent Stagnation. Patients can consume these herbs to improve their skin condition under the guidance of a TCM practitioner.
- Milkvetch root (huang qi, 黄芪)
- Atractylodes rhizome (bai zhu, 白术)
- Chinese yam
- Chinese Angelica root (dang gui, 当归)
- Rehmannia root (shu di, 熟地)
- Red dates (hong zao, 红枣)
- Dried longan
Herbs that encourage optimal cell renewal, like bird’s nest (yan wo, 燕窩), are also good for wound healing. Topical herbal medicine may also help. A 2020 study published in Chinese Herbal Medicines found that a six-herb TCM ointment resulted in shrinking and fading scar tissue in animal models.
Acupuncture and gua sha
Most keloid scars are not painful, but for those that do cause pain, acupuncture may be able to help. In a 2014 case report, acupuncture helped a 48-year-old female patient suffering from severe scar pain.
Acupuncture treatment will do little to reduce an existing keloid scar, however. For this, physician Goh suggests a gua sha massage around the keloid scar to prevent it from getting bigger. Gua sha is an alternative therapy that involves scraping your skin with a massage tool to improve microcirculation of tissue, which can help prevent keloid formation and remove Stagnation.
How to Prevent or Reduce the Likelihood of a Keloid Scar
Being prone to getting keloids doesn’t mean all hope is lost. Here are some guidelines to consider if you already have a keloid or are considering a skin-altering procedure.
Consider alternatives to traditional pierced earrings and tattoos
You may want to try earrings, many of which require an ear piercing. However, there are alternatives, such as clip-on or stick-on earrings. Similarly, if you’re interested in skin art, temporary or henna tattoos don’t puncture the skin or cause scarring.
Try skin alterations or punctures on a small spot first
If you’re still keen on a piercing or tattoo, do a test run on a smaller and less visible area of your body. Watch for thickening skin, as this is the first sign that a keloid is likely to form.
Use pressure treatment at first sight of thickening
For a keloid scar that is just starting to form, pressure treatment may help. The goal is to prevent further keloid formation by applying pressure directly on the affected skin. Wear a pressure earring or pressure garment for at least 12 hours a day for four to six months.
Early-response wound care
An accidental injury may sometimes cause a keloid scar on the skin. In this case, attending to the wound as early as possible is critical. A wound that heals well is more likely to have a smaller scar.
Avoid using disinfecting liquids that are very drying, such as rubbing alcohol, iodine, or hydrogen peroxide. The dryness can interfere with optimal healing. Once the wound has healed, use silicone gel or silicone gel sheets to discourage keloid formation. Remember to use sun protection too.
Keloid scars are still a bit of a dermatological mystery. Holistic approaches to health and medicine also help us understand them in the context of internal health. Share this article if you know anyone with keloid scars.
- Cleveland Clinic. 2021. Scars. [online] Available at: <https://my.clevelandclinic.org/health/diseases/11030-scars> [Accessed 1 October 2022]
- American Academy of Dermatology Association. 2022. Keloid Scars: Self Care. [online] Available at: <https://www.aad.org/public/diseases/a-z/keloids-self-care> [Accessed 1 October 2022]
- National Health Service (NHS), United Kingdom. 2019. Keloid scars. [online] Available at: <https://www.nhs.uk/conditions/keloid-scars/> [Accessed 1 October 2022]
- FamilyDoctor.org. 2020. Keloids. [online] Available at: <https://familydoctor.org/condition/keloids/?adfree=true> [Accessed 1 October 2022]
- Chinese Herbal Medicines. 2020. A six-herb Chinese medicine composition ointment as a promising candidate for the treatment of hypertrophic scars. [online] Available at: <https://www.sciencedirect.com/science/article/pii/S1674638420301301> [Accessed 1 October 2022]
- Journal of Acupuncture and Meridian Studies. 2014. The Successful Treatment of Pain Associated with Scar Tissue Using Acupuncture. [online] Available at: <https://www.sciencedirect.com/science/article/pii/S2005290114000922> [Accessed 1 October 2022]
- Burns and Trauma. 2018. Chinese expert consensus on clinical prevention and treatment of scar. [online] Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6154406/> [Accessed 1 October 2022]
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