A keloid is a type of raised scar that occurs when the body produces an excessive amount of collagen at the site of a skin injury. This overgrowth of dense, fibrous tissue extends beyond the original wound boundaries, unlike a typical scar. Keloids are challenging to manage at home due to their aggressive growth pattern and high potential for recurrence. This article explores accessible, non-prescription methods for managing these scars, focusing on physical techniques and topical applications.
Over-the-Counter Occlusion Methods
Physical management through consistent pressure and hydration represents the most supported home treatment for keloids. Silicone products, available as sheets or topical gels, are considered a first-line, non-invasive method purchased over the counter. They work primarily by occluding the skin to reduce transepidermal water loss.
Maintaining this moisture balance helps to normalize the production of collagen, which is overactive in keloid formation. Silicone also slightly increases the scar’s temperature, which may activate enzymes that break down excess collagen. For a significant reduction in thickness and redness, silicone sheeting or gel must be worn consistently for 12 to 24 hours per day.
Achieving results requires long-term commitment, typically spanning three to six months or more. Pressure dressings, such as specialized garments or compression tape, provide mechanical force to flatten the scar tissue and limit its blood supply. For keloids on the earlobe following a piercing, a specialized pressure earring can provide the necessary continuous compression to encourage the scar to soften and shrink.
Natural and Topical Home Applications
Many people look to natural remedies applied directly to the scar’s surface, though these methods have less rigorous scientific backing than physical occlusion. Onion extract, a common ingredient in commercial scar gels, contains flavonoids that may inhibit fibroblast proliferation and reduce inflammation. Studies suggest onion extract is more effective at improving scar color than height and is often best used in combination with silicone.
Apple cider vinegar (ACV) is frequently cited as a home remedy due to its astringent and exfoliating properties. Applying a diluted solution of ACV may help reduce the keloid’s redness and size by preventing the accumulation of dead skin cells. Honey can also be applied for its soothing and moisturizing qualities, which may help soften the dense scar tissue.
Some individuals use oils like vitamin E or tea tree oil, but caution is necessary with any topical application. Undiluted ACV can cause skin irritation, and some natural oils may trigger an allergic reaction or dermatitis. Always test any new application on a small area of skin first, and discontinue use if irritation occurs.
Preventing Keloid Formation and Recurrence
Since keloids result from an abnormal healing response, prevention is the most effective approach, particularly for those with a known predisposition. Proper wound care immediately following a skin injury is necessary, involving gentle cleaning and keeping the wound moist with a sterile dressing. Minimizing tension on the healing skin is fundamental, as physical stress is a major trigger for keloid development.
Individuals prone to keloids should avoid non-medical elective procedures like body piercings, tattoos, or unnecessary cosmetic surgeries. If a wound is sustained, the consistent use of silicone products or pressure therapy can significantly reduce the risk of a new keloid forming. Protecting a healing wound or an existing keloid from sun exposure is necessary, as ultraviolet light can cause the scar to darken, making it more noticeable.
When to Seek Professional Treatment
Home methods are suitable for managing small, non-symptomatic keloids, but they may be insufficient for larger or more aggressive scars. It is advisable to seek medical intervention if a keloid is rapidly growing, becomes painful or intensely itchy, or restricts movement, especially near a joint. Home treatments should be re-evaluated if they fail to produce noticeable flattening or softening after three to six months of consistent use.
A physician, often a dermatologist, can offer several clinical treatments that are more potent than over-the-counter options. The most common first-line treatment is a series of corticosteroid injections directly into the keloid, which reduces inflammation and shrinks the scar. Other professional methods include cryotherapy, which involves freezing the scar with liquid nitrogen, or laser therapy to reduce height and color.
Surgical removal is an option for large keloids, but it is rarely performed alone due to the high rate of recurrence. Surgery is almost always combined with follow-up treatments, such as post-operative pressure therapy or low-dose radiation, to suppress the aggressive healing response. Consulting a professional ensures a combination therapy approach tailored to the scar’s size and location.