Keloid scars represent an overgrowth of dense, fibrous scar tissue that extends significantly beyond the original injury site. This excessive healing response is a frustrating and often challenging skin condition. Flattening these raised formations is primarily desired for cosmetic improvement, but it can also enhance function by increasing tissue flexibility and reducing symptoms like pain and itching. This article focuses exclusively on non-invasive, home-based methods that can help manage and reduce the prominence of keloids.
Topical Gels and Natural Extracts for Reduction
Topical treatments derived from natural sources offer a non-invasive approach to keloid management, often targeting the inflammation and excessive collagen production associated with the scar. One of the most studied non-medical topicals is Onion (Allium Cepa) extract gel. Onion extract is believed to work by inhibiting the proliferation of fibroblast cells that produce collagen and reducing inflammation within the scar tissue.
Research suggests that while onion extract may be effective at improving the color and overall appearance of keloids, it is less effective at reducing the scar’s actual height when used alone. Therefore, it is often recommended to use onion extract in combination with other physical flattening techniques for the best results. Aloe Vera gel is known for its anti-inflammatory properties and its ability to keep the skin hydrated. It may also help modulate collagen production, and its saponin content can offer antiseptic benefits beneficial for newly healed tissue.
Honey has also been explored for its anti-scarring effects due to its anti-inflammatory and antibacterial properties. Honey creates a moist healing environment, which can help minimize the potential for hypertrophic scarring. These extracts should be massaged gently into the scar two to three times daily after the wound has completely closed.
Physical Pressure and Occlusion Techniques
The most consistently effective non-invasive method for flattening keloids involves sustained physical pressure and occlusion. Silicone sheets and gels are considered the standard non-surgical home treatment for reducing the size and prominence of keloid and hypertrophic scars. Silicone products work primarily by causing the scar tissue to become hydrated, achieved by covering the area and reducing the natural rate of water loss from the skin’s surface.
This increased moisture signals the skin cells to stop producing the excess collagen that forms the keloid. The occlusive barrier also increases the temperature of the scar. To be effective, silicone sheets or scar tapes must be worn continuously, ideally for 12 to 24 hours per day, and this regimen must be maintained for several months.
Pressure garments and dressings are also utilized, especially for large or widespread keloids, by applying a constant, uniform mechanical force to the tissue. This sustained pressure is thought to reduce blood flow and oxygen to the scar, which decreases the production of new collagen and helps the existing tissue reorganize and flatten. For keloids on the earlobe, specialized pressure earrings are often recommended to maintain the necessary compression.
Massage and Hydration Strategies
Physical massage is a simple strategy that works to mechanically soften and flatten keloid tissue by manipulating the dense collagen fibers. The goal of scar massage is to break up internal adhesions and increase the flexibility of the scar, helping it integrate better with the surrounding healthy skin. Massage should only be initiated once the original wound has fully healed and there are no open areas or scabs.
Effective techniques include deep, firm pressure applied in circular motions directly over the scar, or cross-friction massage, which involves rubbing perpendicular to the scar’s length. Apply enough pressure to make the scar tissue move underneath the skin, rather than just sliding fingers across the surface. These massage sessions should be performed two to three times daily, lasting about five to ten minutes each time.
Using a hydrating agent during the massage helps reduce friction and keep the tissue pliable. While the evidence for topical Vitamin E oil is mixed, it is often used as a lubricating agent. Other common moisturizers like coconut oil, shea butter, or simple, unscented lotions can be used to maintain the scar’s hydration, which is crucial since scar tissue loses water more easily than normal skin.
Setting Realistic Expectations and Safety
Managing keloids with home-based, non-invasive methods requires a significant commitment and a realistic outlook on the timeline for improvement. Keloids are notoriously resistant to treatment, and even with diligent application of topical products, pressure, and massage, results can take months, not weeks, to become noticeable. It may take six to twelve months of consistent daily treatment to achieve the best possible outcome.
Home treatments are generally most effective on newer keloids, and while they can soften, flatten, and lighten the scar, they may not eliminate it entirely. If the keloid continues to grow, becomes increasingly painful, or shows no improvement after several months of consistent home care, it is time to consult a dermatologist. A specialist can offer medical interventions, such as steroid injections or cryotherapy, which are often necessary to halt the progression of the scar and achieve further reduction.