Do keloid scars recur after treatment?

Yes, it is possible for keloid scars to reappear after treatment. In fact, keloids are considered conditions that are difficult to eliminate permanently, as the rate of recurrence after surgical excision alone can reach high levels approaching 100% in some cases [4]. For this reason, doctors usually do not recommend relying on surgery alone; instead, they prefer using combined treatment plans to reduce this possibility.

Why do keloid scars recur?

A keloid scar is not just an ordinary scar; it is an excessive response of the body during wound healing, where the skin produces excessive amounts of collagen, causing the scar to grow larger than the area of the original wound [3]. Since the body retains a "memory" or a genetic predisposition to produce this excess tissue, any new trauma to the skin—even if it results from surgery to remove the keloid itself—may stimulate cells to reproduce the scar even more densely [3]. Factors that increase the likelihood of recurrence include age (especially the age group from 10 to 30 years), genetics, and the location of the scar on the body [3].

Strategies to reduce the chances of keloid recurrence

Due to the difficulty of completely preventing recurrence, dermatologists focus on using multiple treatments in combination. Options available to enhance results include topical corticosteroid injections that help shrink the scar, the use of silicone sheets or gel that work to flatten the scar's appearance, and cryosurgery, which is used to freeze the scar from the inside [4]. More details about preventive and therapeutic methods can be found in our article on Hypertrophic and Keloid Scars: Understanding the Differences and Available Treatment Options (Arabic).

In some cases, radiation therapy (under strict supervision and after specialist consultation) is used after surgery to significantly reduce recurrence rates. This method may be used when scars do not respond to less invasive treatments [4].

When should you consult a doctor?

If you have undergone treatment for a keloid scar, it is essential to monitor the area closely. Signs of recurrence often include itching, pain, or noticing a gradual increase in the size or firmness of the scar after a period of stabilization [3]. It is very important to see a specialist physician immediately upon noticing any abnormal growth at the site of the previous procedure. Avoid attempts to remove scars at home or resorting to non-medical procedures such as piercings (tattoos or cosmetic piercings) in places that have previously experienced keloids, as these practices may increase the risk of developing new, more complex scars [3].

Medical references

• Keloid scars - NHS
• Keloid scars: Diagnosis and treatment