Symptoms & Treatment: Keloid scars

Benign disease services
Keloid scars

What are keloid scars?

A keloid scar is a benign, overgrown lump that can sometimes develop when a wound heals, or even after minor skin damage such as acne or ear piercing.^2,3 They may be red or darker in colour than usual skin tone, and appear most commonly on the chest, shoulders, and ear lobes.^2,3 They are often cosmetically disfiguring but can also cause itching and pain.^2,3

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To learn more about radiation therapy treatment options for keloid scars, make an enquiry. Please note a referral from a GP or specialist is needed for an initial assessment by a radiation oncologist.

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What causes keloid scars?

It’s not known exactly what causes keloid scars, but they are more common in people with darker skin than lighter skin.^2,3 They usually develop in people aged 10 to 30 years but can occur at other ages.²

Keloid scars form when excessive amounts of collagen (a protein used in wound repair) are produced in areas that are healing after skin injury.^2,3 They typically develop slowly and will usually appear months after the surgery or injury to the skin.^2,3

While keloid scars and hypertrophic scars share similarities in appearance (raised and red scars), they grow differently: keloid scars grow beyond the original edges of injury into surrounding tissue, while hypertrophic scars remain within the edges of the initial injury.^2,3

How are keloid scars treated?

Most options for treating keloid scarring aim to flatten and improve the appearance of the scar, as well as reducing any associated symptoms.³

Management of keloid scars may include one or more different therapies, often used in combination, that help to reduce inflammation in the skin.^1,2

Your specialist may advise you to try certain treatments to help reduce inflammation. If these treatments haven't worked for you, then careful surgery combined with precision radiation therapy may be appropriate for you.²

Radiation therapy for keloid scars

Assessment

An initial assessment and discussion is important to help understand the uncertainties and alternative treatment options.

At the assessment, your specialist will discuss whether radiotherapy might be helpful for your condition, as well any as side-effects you may experience.

Note: You will need a referral from a GP or specialist for an assessment.

Treatment

Radiation therapy may help treat keloid scars by reducing the inflammation which in turn dampens the excess production of collagen.^1,4 Radiation therapy can be used after surgery, with the aim of preventing the scar from recurring; studies show success rates around 80% to 85% with no regrowth of the scar.^2,5

Radiation therapy for keloid scars can use a technique called electron beam radiation therapy, which is delivered by a linear accelerator (LINAC).² Radiation therapy is often started approximately 24 to 72 hours after surgery and may be delivered in up to five treatments sessions within one week.^2,4,6

The number of treatment sessions, their duration, and treatment outcomes will vary between patients. Side effects may occur, but these are usually mild to moderate. For example, some patients experience mild redness of the skin immediately following treatment, which this usually subsides over 3 to 4 weeks.⁵

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Content reviewed by

Review Date: October 2024

Prof Jarad Martin

MBChB BSc PhD DMed, FRANZCR GAustMS

Radiation Oncologist

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References

Ogawa R. Keloid and Hypertrophic Scars Are the Result of Chronic Inflammation in the Reticular Dermis. Int J Mol Sci. 2017;18(3):606.
Zainib M, Amin NP. Radiation Therapy In The Treatment Of Keloids. [Updated 2022 Aug 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499973/ [accessed April 2023].
Australasian College of Dermatologists. Keloids. August 2015. Available: https://www.dermcoll.edu.au/atoz/keloids/ [accessed April 2023].
Nast A, Gauglitz G, Lorenz K, et al. S2k guidelines for the therapy of pathological scars (hypertrophic scars and keloids) - Update 2020. J Dtsch Dermatol Ges. 2021;19(2):312-327.
Lee SY, Park J. Postoperative electron beam radiotherapy for keloids: treatment outcome and factors associated with occurrence and recurrence. Ann Dermatol. 2015;27(1):53-58.
Wen P, Wang T, Zhou Y, Yu Y, Wu C. A retrospective study of hypofractionated radiotherapy for keloids in 100 cases. Sci Rep. 2021;11(1):3598.

Disclaimer:

This website is provided for information purposes only. Nothing on this website is intended to be used as medical advice, or to diagnose, treat, cure or prevent any disease. It should not be used as a substitute for your own health professional's advice. Any medical procedure or treatment carries risks. Before proceeding with treatment, you should discuss the risks and benefits of the treatment with an appropriately qualified health practitioner. Individual treatment outcomes and experiences will vary.

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