Keloid Scars

Common Symptoms

• A raised, firm scar that extends beyond the original wound or injury boundary
• Discoloration (often darker or pink/red) of the scar tissue
• Itching or tenderness, sometimes significant, at the scar site
• Scars that can continue to grow over months to years without treatment

Why It Happens

Keloids form when the skin's wound-healing process overproduces collagen, extending scar tissue beyond the original injury site — a tendency that's strongly influenced by genetics and is more common in certain skin types.

Why It Can Become Persistent

Once formed, keloid tissue generally doesn't shrink or resolve on its own the way normal scars fade, and keloids have a notable tendency to recur even after treatment, which is part of why they're considered a genuinely difficult condition to manage.

Who Commonly Gets It

Keloids are significantly more common in people with darker skin tones and often run in families; they can form after any skin injury, including piercings, acne, surgery, or even minor cuts.

How It Is Usually Diagnosed

Diagnosis is clinical, based on the characteristic appearance of scar tissue extending beyond the original wound margin.

Traditional Treatment Options

• Intralesional corticosteroid injection: The current standard first-line treatment, often used in a series of sessions.
• Silicone sheeting or gel: Can help with flattening and symptom control, particularly for prevention or milder cases.
• Cryotherapy: Freezing treatment, sometimes combined with steroid injection.
• Surgical excision: Carries a real risk of the keloid recurring, often larger, unless combined with other treatments.

Why Someone Might Start Looking for Another Option

Because keloids are notoriously difficult to treat and prone to recurrence, there's genuine interest in additional or alternative non-invasive options, including shockwave therapy.

Where Shockwave Therapy May Fit

A systematic review of 12 studies found shockwave therapy alone produced functional and cosmetic outcomes comparable to intralesional steroid injection, and that combining the two outperformed steroid injection alone. A randomized comparative trial of 39 patients found no significant difference in overall cosmetic and functional outcome between shockwave therapy and steroid injection, though tissue analysis showed shockwave therapy produced a greater reduction in the collagen types associated with keloid formation. This is real, genuinely encouraging comparative evidence — shockwave therapy performing similarly to, and possibly complementing, the current standard treatment — though from a still-limited number of studies with short follow-up periods relative to how slowly keloids form and recur.

How Shockwave Treatment Works for This Area

Acoustic pressure waves are applied to the keloid tissue, either as a stand-alone approach or combined with steroid injection depending on your evaluation and preferences.

What the Treatment Feels Like

Most patients describe a firm tapping or pressure sensation over the scar tissue; your provider will discuss what to expect.

What Happens During Your First Visit

Your visit begins with a provider evaluation focused on your history and a physical exam relevant to your complaint. If shockwave therapy is determined to be clinically appropriate, your first treatment can typically be provided the same visit. See our What to Expect page for the full walkthrough.

Who May Not Be Appropriate

• Anyone who has not yet had a medical evaluation to confirm the diagnosis
• Active infection or open skin breakdown at the treatment site
• Certain circulatory, neurological, or bleeding-related conditions, per your provider's screening

This list is not exhaustive. Your provider will screen for contraindications during your evaluation.