Quick answer. A keloid is an overgrown scar that extends beyond the original wound and does not fade on its own. Keloids are more common in darker and Asian skin and on the ears, chest and shoulders; treatments such as steroid injections, silicone, laser and surgery can improve them but recurrence is common.
Keloid scars are a common concern in Singapore, particularly because they tend to affect people with darker and Asian skin tones more often. Unlike a normal scar, a keloid is an overgrowth of scar tissue that spreads beyond the edges of the original wound, forming a raised, firm, often itchy or tender lump. They commonly develop on the earlobes after piercings, and on the chest, shoulders, upper back and jawline.
While keloids are harmless and not cancerous, they can be itchy, uncomfortable and distressing because of their appearance. This guide explains what a keloid is, why some people are prone to them, how they are assessed, and the treatment options available, while being honest that no treatment guarantees a cure and keloids often need ongoing management.
At a glance
| Treatment | How it works | Notes |
|---|---|---|
| Silicone gel or sheets | Flattens and softens the scar over months | Often first-line, needs consistent daily use |
| Steroid injections | Reduces inflammation, flattens and softens the keloid | Usually a course of injections, may be repeated |
| Pressure therapy | Continuous pressure, for example earlobe clips | Common after earlobe keloid surgery |
| Laser therapy | Reduces redness and improves texture | Often combined with other treatments |
| Surgical removal | Cuts out the keloid | High recurrence unless combined with injections or other adjuncts |
What is a keloid?
A keloid is a type of raised scar that forms when the body produces too much collagen during wound healing. Instead of stopping once the wound is closed, the scar tissue keeps growing and extends beyond the boundaries of the original injury, which is what distinguishes a keloid from a more common raised scar called a hypertrophic scar that stays within the wound edges.
Keloids are firm, smooth, often shiny lumps that may be pink, red, purple or darker than the surrounding skin. They can be itchy or tender and do not fade or shrink on their own over time. They are more common in people with darker and Asian skin, which makes them a frequent concern in Singapore, and they favour the earlobes (after piercing), chest, shoulders, upper back and jaw. Keloids are benign and not cancerous, but they can cause discomfort and significant distress about appearance.
Symptoms & signs
A keloid develops at the site of skin injury, sometimes months after the original wound. Typical features include:
- A raised, firm, smooth scar that grows beyond the edges of the original wound
- A colour that may be pink, red, purple or darker than surrounding skin
- Itching, tenderness or a sensation of tightness over the scar
- Continued slow growth rather than fading over time
- Common sites such as earlobes, chest, shoulders, upper back and jawline
Keloids are harmless, but a scar that grows rapidly, ulcerates, bleeds or changes in an unusual way should be checked by a doctor to be sure of the diagnosis.
Causes & risk factors
Keloids form because of an exaggerated healing response to skin damage. Risk factors and triggers include:
- Skin injury of almost any kind, including ear and body piercings, acne, cuts, burns, surgery, vaccinations and insect bites
- Having darker or Asian skin, which carries a higher tendency to keloid
- A personal or family history of keloids
- Being a teenager or young adult, when keloids most commonly first appear
- Wounds in high-tension or movement-prone areas such as the chest and shoulders
Because piercings and acne are common triggers, people who are keloid-prone are often advised to be cautious about elective skin procedures.
How it's diagnosed
Keloids are diagnosed clinically, meaning a doctor can usually identify them by examining the scar and noting that it has grown beyond the original wound, along with asking about how it developed and your personal or family history of keloids.
Special tests are rarely needed. In unusual cases, where a growth looks atypical, is changing quickly or the diagnosis is in doubt, a doctor may take a small skin biopsy to confirm it is a keloid and exclude other skin growths. The doctor will also assess the keloid’s size, site and symptoms to plan the most suitable treatment.
Treatment options
Keloid treatment aims to flatten, soften and shrink the scar and relieve itch or discomfort, but it is important to know that keloids can be stubborn and recur, so a combination of treatments and ongoing follow-up is often needed. Options include:
- Silicone gel or sheets: applied daily over months to flatten and soften the scar, often used early
- Steroid injections: injected into the keloid over several sessions to reduce inflammation and bulk
- Pressure therapy: such as pressure earrings or clips after earlobe keloid removal
- Laser therapy: to reduce redness and improve texture, often combined with other methods
- Surgical removal: cutting out the keloid, usually combined with steroid injections, pressure or other adjuncts because surgery alone has a high recurrence rate
- Other options: cryotherapy and additional therapies a specialist may consider
Costs vary considerably with the method, number of sessions and clinic. As a rough guide in private practice in Singapore, a single steroid injection session often falls within a market range of about S$80 to S$300, while surgical excision with adjunctive treatment is more expensive and may run into the region of S$1,000 to several thousand dollars in total, especially as repeat treatments are common. These are typical ranges only, not quotes; cosmetic scar treatment is generally not subsidised, so confirm exact fees with your clinic.
When to see a doctor & which specialist
See a doctor if a scar is growing beyond the original wound, is itchy, painful or unsightly, or if you are keloid-prone and are planning a piercing or procedure and want advice on prevention. Early treatment of a developing keloid tends to work better than waiting until it is large and established. Seek medical review for a scar that grows rapidly, ulcerates, bleeds or looks unusual, so other diagnoses can be excluded. Keloids are not an emergency, but in the rare event of a severe infection or other acute problem with feeling very unwell, you can attend A&E or call 995.
For diagnosis and treatment of keloids, a skin specialist can assess your scar and plan a combination of therapies. You can find one through our directory of dermatologists in Singapore.
Related guides
- Best Dermatology Clinics in Singapore — our editorial shortlist
- dermatology clinics directory
- Folliculitis
- Heat rash
- Sebaceous cyst
- Overactive bladder
- Bursitis
Sources
- NHS – Keloid scars
- Mayo Clinic – Keloid scar
- DermNet – Keloid and hypertrophic scar
- HealthHub Singapore – Health conditions
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