Keloid scars are raised scar tissue that forms when the skin’s healing process becomes overzealous, causing the scar to grow beyond the boundaries of the original wound. While keloids are difficult to eliminate completely without professional intervention, their appearance and uncomfortable symptoms can often be managed through consistent at-home treatments.
Non-Prescription Topical and Mechanical Treatments
Home management focuses on applying continuous mechanical pressure and maintaining a hydrated environment over the scar tissue. Silicone therapy, available as sheets or gels, is often considered the first-line, non-invasive treatment. Silicone works by occluding the skin, which increases the hydration of the outermost layer, the stratum corneum. This hydration is thought to reduce the signaling between skin cells that stimulates excessive collagen production.
For maximum benefit, silicone sheets should be worn for a minimum of 12 to 24 hours per day, and this regimen must be maintained for several months. The sheets can be cut to fit the exact size of the keloid, while silicone gels offer a more discreet option for joints or highly visible areas. Consistency is paramount, as the treatment aims to slowly normalize the scar environment over an extended period.
Pressure therapy involves applying continuous, firm pressure directly onto the keloid. This sustained compression, often delivered through specialized dressings, garments, or pressure earrings for earlobe keloids, helps to flatten the scar. The pressure constricts the blood vessels within the keloid, which limits the supply of oxygen and nutrients needed to support the overgrowth of scar tissue.
To be effective, the pressure must be consistent, with many protocols recommending wear times of 12 to 24 hours daily for at least six to twelve months. The ideal pressure range is typically between 24 and 30 millimeters of mercury (mmHg), which is firm enough to affect the tissue but tolerable for continuous wear. While non-prescription topical hydrocortisone creams do not shrink the keloid, low-dose formulations can offer limited, short-term relief from associated itching or inflammation.
Common Natural Remedies and Their Application
Onion extract, derived from Allium cepa, is a common ingredient that has demonstrated a positive effect on scar color and redness. It is often formulated into a topical gel, which should be applied directly to the keloid once or twice a day according to product instructions. However, studies show that onion extract is not highly effective at reducing the actual height of the scar when used alone, often performing best in combination with a mechanical treatment like silicone sheeting.
Tea tree oil is researched for its anti-inflammatory and antimicrobial properties. There is little scientific evidence that it can shrink an existing keloid scar, but its use is popular for managing the surrounding skin. Due to its potency, tea tree oil must always be diluted with a carrier oil, such as coconut or jojoba oil, typically using only a few drops per ounce of carrier. A patch test should always be performed before widespread use to check for irritation or allergic reaction.
Honey, aloe vera, and Vitamin E function primarily as moisturizing and anti-inflammatory aids. Honey and aloe vera are noted for their hydrating and antimicrobial qualities, helping to soften the hard keloid tissue. Applying these should focus on moisturizing the area to improve pliability and reduce discomfort, rather than expecting significant scar reduction. When using any of these natural remedies, maintaining skin hygiene and conducting a patch test is a sensible precaution.
Recognizing Limitations and Seeking Professional Care
It is important to have realistic expectations for at-home keloid management, as these methods are intended primarily to soften the scar, reduce symptoms, and manage its appearance. Home treatment should be discontinued, and professional evaluation sought if the keloid continues to grow larger despite consistent application of silicone or pressure therapy over six to eight weeks. An increase in the size of the scar or intensifying pain and tenderness are strong indicators that home strategies are insufficient.
Certain signs warrant immediate medical attention, as they may indicate a complication beyond a typical keloid. These warning signs include any evidence of infection, such as pus, spreading redness, or fever, or the presence of ulceration on the scar’s surface. Excessive itchiness that disrupts sleep or daily life is also a reason to consult a specialist.
When home efforts fail to stabilize or improve the keloid, a doctor, often a dermatologist, can offer more potent treatments. These professional options include intralesional corticosteroid injections, which are effective at flattening the scar, cryotherapy (freezing), or laser treatments. While surgical removal is an option, it is often combined with other therapies, as the procedure itself can sometimes trigger a new, larger keloid to form.