Keloids and hypertrophic scars can develop after injuries, piercings, surgery, or acne, and they affect people very differently. Some remain small and cause little more than cosmetic concern; others grow, cause discomfort, and affect how you feel day to day. It is one of the more common reasons people seek treatment at a medical aesthetics clinic in Singapore, from teenagers with ear keloids after a piercing, to adults managing scars from surgery or acne.
At 1Aesthetics in Singapore, Dr Wan Chee Kwang assesses each keloid based on its size, location, thickness, symptoms, skin type, and recurrence risk before recommending a personalised treatment plan. Treatment may include intralesional injections, laser therapy, surgical excision, silicone therapy, or a combination approach to help flatten the scar, improve comfort, and reduce the risk of recurrence.
Speak with Dr Wan about suitable options for your keloid scar treatment in Singapore. Same-week appointments available.
📍 1Aesthetics, Medical & Surgery
#14-90 The Central, 8 Eu Tong Sen Street, Singapore 059818
(Clarke Quay / Chinatown MRT)
📞 +65 6612 5173
💬 WhatsApp: +65 8489 9962
Mon–Fri 9am–7pm | Sat 9am–3pm
1Aesthetics is a licensed medical clinic in Singapore. Dr Wan Chee Kwang holds a Singapore Medical Council (SMC) licence and is SMC-accredited for Aesthetic Procedures. All treatments are performed in accordance with MOH guidelines.
Keloids and hypertrophic scars are large, thickened, raised growths that form when the skin heals abnormally after an injury, surgery, or inflammation producing excess collagen and scar tissue.
The key difference is:
Both types of scars can occur after acne, piercings, cuts, burns, surgery, or other skin trauma. They may not improve on their own and can recur after treatment, which is why proper assessment and follow-up care are important.
Keloids most commonly appear on the jawline, ears, chest, back, and shoulders, and can develop after any type of skin injury.
Keloids may form after almost any skin injury or inflammation. Common triggers include:
Other contributing factors include:
Type of injury or surgery: The nature of the trauma, whether burns, piercings, surgical cuts, or acne, can influence whether a scar becomes hypertrophic or keloid.
Skin tension and wound depth: Areas where the skin stretches or is constantly under tension are more likely to form raised scars.
Delayed healing or infection: Wounds that take longer to heal or become infected can result in excess scar tissue.
Genetic factors: Some people—especially those with darker skin tones or a family history of keloids—are more likely to develop them.
Keloids can occur anywhere but are more common in areas where the skin is under tension or where inflammation is frequent.
One of the most important things to understand about keloids is that treatment rarely ends with a single procedure. Recurrence is a defining feature of keloid biology, and the choice of treatment has a direct bearing on how likely a keloid is to come back.
Surgical excision alone carries a recurrence rate of 45% to 100%, and recurring keloids are often larger than the original. This is why excision by itself is rarely recommended without additional post-operative therapy.
Combining surgery with adjunct treatments reduces that risk substantially. When excision is followed by intralesional corticosteroid injections, most studies cite recurrence rates below 50%, with some protocols achieving rates as low as 9%. Timing matters too: a systematic review and meta-analysis found that post-operative steroid injection produces significantly lower recurrence rates than injections given before or during surgery.
For non-surgical approaches, steroid injections used as a standalone treatment can be effective for softer, less established keloids. Response rates range from 50% to 100%, with recurrence rates of 9% to 50% in scars that resolve completely.
Published recurrence rates vary widely across studies because of differences in scar type, treatment method, follow-up duration, and patient risk factors. Indicative recurrence rates reported in medical literature include:
| Treatment Approach | Approximate Recurrence Rate |
| Surgical excision alone | 45–100% |
| Excision + post-operative steroid injections | 9–50% |
| Intralesional steroid injections (standalone) | 9–50% |
| Intralesional excision (e.g. KILE technique) | ~13% (pooled) |
| Excision + radiotherapy | 3–32% |
These figures are general literature ranges and may not predict an individual patient’s outcome. Dr Wan will discuss your recurrence risk during consultation.
A keloid might start small and easy to ignore, until it isn’t. Whether it’s something you notice in the mirror, feel under your clothes, or get asked about by others, these scars can slowly affect how you go about your day.
The table below provides indicative fee ranges for common keloid treatments at 1Aesthetics. All figures are estimates only. Your actual fee will depend on the size, location, number, and complexity of your keloid(s), and will be confirmed following a clinical consultation with Dr Wan.
| Treatment | Estimated Fee Range (SGD) | Scope of Treatment | Estimated Sessions Required |
| Intralesional Steroid Injection | Starting from $100–$300 per session | Corticosteroid injected directly into the keloid under topical anaesthesia, frequently combined with other injectable agents (such as neurotoxin) depending on the keloid's response; may include a post-injection review | Typically 3–6 sessions at 4–6 week intervals, subject to individual tissue response |
| Surgical Excision | $1000–$3,000+ per lesion | Consultation, local anaesthesia, surgical removal, and wound closure; post-operative review included | Typically one surgical procedure, followed by adjunct suppression therapy; number of follow-up sessions subject to clinical assessment |
| Laser Treatment (CO2 / Vascular) | $300–$1,200 per session | Laser application under topical anaesthesia; usually combined with injection therapy in the same session | Typically 3–6 sessions depending on keloid type, depth, and response to treatment |
Keloid treatment often involves a combination of methods. The recommended approach depends on the keloid’s size, thickness, age, symptoms, location, and previous treatment history.
Common treatment options include:
Combination treatment
No single treatment is suitable for every keloid, and recurrence remains possible even after successful flattening or removal. Laser and non-surgical treatments may be suitable for selected keloids, particularly smaller, softer, red, itchy, or less established scars. These treatments are often combined with injections or other forms of scar suppression.
CO2 Laser for Keloids
CO2 laser treatment uses targeted energy to remove or remodel thickened scar tissue. CO2 laser may be considered for selected raised scars, especially when precision tissue reduction is required. CO2 laser may help:
Downtime varies depending on treatment intensity and scar location.
Radiofrequency Ablation for Keloids
In selected cases, radiofrequency may be used as part of a minimally invasive or surgical treatment plan. Radiofrequency may help:
Suitability depends on the keloid’s depth, location, and recurrence risk.
Vascular laser keloid treatment helps reduce redness and bulk by targeting blood vessels feeding the keloid. The laser’s photothermal effect damages the vessel walls, prompting the body to naturally eliminate the vessels. This reduces redness and gradually shrinks the scar.
Multiple vascular lasers can be used to target keloids that appear red, active, or vascular.
Vascular laser treatment may help:
Multiple sessions are usually required.
Corticosteroid injections are used to suppress excessive inflammation and collagen formation in keloids and hypertrophic scars. In Dr Wan's practice, they are frequently combined with other injectable agents rather than used alone, as this can improve response and help offset individual side effects.
Other injectable options for keloids include antimetabolites (drugs that block collagen production in scar tissue), antiproliferative antibiotics (which slow the cells responsible for excess scarring), and calcium channel blockers (which help break down existing collagen, though more slowly and with less effect than steroids). These are less commonly used in Singapore due to cost and limited availability. Neurotoxins, covered below, are also a frequent combination partner with steroid injections in practice.
Correct concentration, dosage, and depth remain essential to avoid side effects such as skin thinning or depression. For a fuller comparison of these alternatives, see this article.
Neurotoxins are increasingly used off-label for keloid management. Studies show they can reduce pain, itching, and scar thickness, especially when combined with steroid injections. They offer a lower risk of side effects such as injection pain or skin atrophy.
Surgical excision may be considered for selected keloids that are large, thick, symptomatic, or less responsive to non-surgical treatment. However, surgery is not suitable for every patient because keloids can recur after removal.
At 1Aesthetics, Dr Wan assesses whether surgery is appropriate based on the scar’s location, size, depth, tension, and previous recurrence pattern. Surgery is typically combined with post-operative suppression therapy to help reduce the chance of regrowth.
Surgery is performed under local anaesthesia, administered after topical numbing cream has been applied to the area. Depending on the keloid, surgical approaches may include:
Shave excision: Removes the raised portion of the keloid to flatten the skin surface. Suitable for selected superficial scars where the keloid has a narrow base. However, shave excision often cannot remove the deeper portion of the scar and is therefore not ideal for many thicker or more deeply seated ear keloids.
Full-thickness extra-lesional excision: Removes the keloid beyond its visible margins. Used for larger or more aggressive scars where complete removal is the priority.
Intralesional fillet flap technique: Preserves surrounding skin while reducing scar bulk, helping to minimise wound tension during healing and lower the risk of recurrence.
Technology-assisted tools including CO2 lasers, vascular lasers, and high-frequency radiofrequency devices are used where appropriate to improve precision, reduce intraoperative bleeding, and limit damage to surrounding tissue. The procedure itself typically takes 1 to 3 hours, depending on the size and complexity of the keloid.
Recovery depends on the size and location of the keloid, the surgical technique used, and the individual’s healing response.
In general:
Dr Wan will provide wound care instructions and a review schedule after the procedure.
Surgery addresses the physical bulk of the keloid, but it does not eliminate the underlying tendency for the skin to overproduce collagen at the wound site. As outlined in the recurrence section above, adjunct suppression after surgery is what separates a manageable outcome from a returning keloid.
At 1Aesthetics, Dr Wan's approach is pre-emptive rather than reactive: rather than waiting for signs of regrowth and treating them as they appear, injections, frequently combined with other injectable agents such as neurotoxin, are used to suppress the wound's tendency to overheal throughout the period when recurrence risk is highest. This typically follows the phases of wound healing:
At the time of surgery: An initial injection is given during the procedure itself, to begin suppressing collagen overproduction from the earliest stage of healing.
Week 2: A further injection is given once the wound has closed and initial healing is underway, targeting early collagen overproduction before it becomes established.
Week 4-8: Further injections are administered as the remodelling phase accelerates. Dose and concentration are adjusted based on the wound's response to previous injections.
Week 8+: Suppression continues into the later remodelling phase, when residual keloid activity is most likely to drive recurrence.
Most patients require more than three injections in total. Depending on individual healing, suppression is typically continued for six to 12 months, in line with the natural timeline for scar maturation. Combination injections may be used at any stage of this protocol, and the number of injections, dosage, agents, and intervals may all be adjusted based on how your skin responds at each review.
Managing Itching and Painful Keloids
Some keloids can itch, ache, sting, or feel tender. While medical treatment may be needed for persistent symptoms, some measures may provide temporary relief:
Seek medical review if the scar becomes increasingly painful, red, swollen, or grows quickly. Over-the-counter creams may provide temporary relief but are unlikely to remove established keloids.
Keloids are commonly seen in medical aesthetic practice, including ear keloids after piercings, jawline keloids after acne, knee keloids after injuries, and scars following surgery or mole removal.
Even regular people who would not otherwise step into a medical aesthetics clinic seek keloid removal treatment in Singapore. For example, young girls who develop ear keloids after botched piercings, knee keloids after a fall, or young men with acne-induced keloid scarring along the jawline. Keloids can also develop after mole removal procedures.
Because keloids behave differently from ordinary scars, treatment should not only focus on flattening or removing the visible scar. It should also address the risk of regrowth through follow-up care, scar suppression, and early management of recurrence.
Address:
1Aesthetics, Medical & Surgery
#14-90 The Central Tower 1
8 Eu Tong Sen Street
Singapore 059818
Mon-Fri 9 AM to 7 PM
Sat 9 AM to 3 PM
Phone / WhatsApp:
+65 66125173 / +65 84899962
Email:
info@1aesthetics.com