Concierge dermatology · London
Keloid scar treatment London.
Consultant-led keloid care in central London. Intralesional triamcinolone with 5-FU, cryotherapy, silicone therapy, surgical excision combined with adjuvant superficial radiotherapy or steroid, and vascular laser for redness and itch.
In short
Excision alone recurs in over half of cases. Excision plus adjuvant superficial radiotherapy or a structured steroid programme is the durable answer. Consultant-led, from £250.
What keloids are
Fibroproliferative dermal scars.
A keloid is a fibroproliferative dermal scar that grows beyond the boundary of the original wound and does not regress on its own. That behaviour separates it from a hypertrophic scar, which stays within the wound edge and often softens over 12 to 24 months.
Keloids commonly form on the earlobes after piercing, the chest, shoulders, upper back and jawline, and can follow acne, surgery, burns, vaccinations or minor trauma. They are more common in darker skin phototypes and in patients with a family history. Beyond appearance, they can be itchy, painful, tender to pressure and restrict movement across joints.
First-line non-surgical
Injection, freezing, silicone.
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Intralesional triamcinolone acetonide
10 to 40 mg/mL injected monthly for three to six sessions. Flattens 50 to 70% of keloids and reduces itch and pain. Higher concentrations for thicker lesions.
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Combined triamcinolone + 5-fluorouracil
Adding 5-FU 50 mg/mL to steroid improves flattening and reduces recurrence versus steroid alone. Standard for refractory or bulky keloids.
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Cryotherapy
Useful as an adjunct for small keloids, and to soften larger lesions before steroid injection. Risk of hypopigmentation, especially in darker skin.
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Silicone gel or sheeting
Applied 12 or more hours a day for three to six months. Modest but reproducible effect on flattening, colour and symptoms. Cheap, safe and first-line adjunct.
Surgical excision
Never on its own.
Excision alone has a recurrence rate above 50%, and the recurrent keloid is usually larger than the original. Surgery is only appropriate when combined with an adjuvant that suppresses the fibroblast response during wound healing.
Excision + intralesional steroid: steroid is injected into the wound edges at closure, then repeated monthly for six months. Recurrence rates 20 to 40%.
Excision + adjuvant superficial radiotherapy: 12 to 15 Gy in three fractions delivered within 24 hours of surgery. Most durable option, with recurrence below 15% in most published series. Preferred for chest, shoulders, larger lesions and repeat recurrences.
Earlobe keloids
Post-piercing, and very treatable.
Earlobe keloids are the most common presentation, almost always following ear piercing. Standard care is excision, followed by a pressure earring worn 12 or more hours a day for three to six months and a programme of intralesional steroid every four weeks. Recurrence with that combination is 10 to 30%. For very large lobules, repeat keloids or high-risk patients, adjuvant superficial radiotherapy is added.
Other options
Adjuncts and refractory disease.
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Intralesional cryosurgery (Kryomed)
A cryoprobe passed through the keloid freezes it from within. Better volume reduction than surface cryo, with less pigment loss.
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Intralesional verapamil
Calcium-channel blocker that softens collagen. Useful when steroid is not tolerated or has plateaued.
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Intralesional bleomycin
Reserved for refractory keloids. Effective but requires specialist supervision.
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Imiquimod 5% cream
Applied post-excision to modulate the immune response and reduce recurrence, particularly on earlobes.
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Pulsed-dye laser
Reduces vascularity, redness and itch. Typically three to six sessions spaced four to six weeks apart.
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Fractional non-ablative laser
Improves texture and reduces pain and itch. Also opens micro-channels for laser-assisted drug delivery of steroid.
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Botulinum toxin
Emerging adjunct that reduces mechanical tension across a healing wound and may lower recurrence.
Prevention
If you are keloid-prone.
- Silicone from day one: apply silicone gel or sheeting as soon as the wound is closed, and continue for three to six months.
- Pressure garments: essential after burns and large excisions on the chest, shoulders and neck. Worn 22 hours a day for six months.
- Avoid unnecessary elective surgery: including cosmetic procedures, elective piercing and non-essential biopsies at high-risk sites.
- Early intervention: a nodule that is still growing at six weeks should be reviewed. Early steroid injection is far more effective than late.
Cost
Private keloid treatment cost in London.
| Item | Indicative price | Notes |
|---|---|---|
| Consultant dermatology or plastic surgery assessment | £250 to £450 | Initial appointment |
| Intralesional injection (triamcinolone or triamcinolone + 5-FU) | £180 to £320 per session | Monthly x 3 to 6 |
| Surgical excision | £950 to £2,400 | Depends on size and site |
| Adjuvant superficial radiotherapy (3-fraction course) | £2,400 to £4,500 | Given within 24 hours of excision |
| Laser session (pulsed-dye or fractional) | £180 to £320 | Course of 3 to 6 |
| Imiquimod 5% cream | £45 to £85 per tube | Post-excision |
| Silicone gel or sheeting | £15 to £45 per month | Ongoing 3 to 6 months |
Prices vary by clinic and consultant. We quote firm figures across two or three options within one working day.
Where in London
Vetted London providers.
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Cadogan Clinic Keloid Service
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Cranley Clinic, Harley Street
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London Dermatology Centre
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HCA Wellington Dermatology
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Chelsea and Westminster Private
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King’s Private Keloid Clinic
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GenesisCare superficial radiotherapy
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Rutherford Cancer Centres
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Skin Care Clinic, Kensington
Frequently asked
Keloid treatment FAQs.
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Can keloids be cured?
There is no permanent cure. Keloids are controlled rather than cured. The most durable results come from surgical excision followed immediately by adjuvant superficial radiotherapy or a structured programme of intralesional steroid injections, combined with pressure therapy and silicone. Long-term follow-up is essential because recurrence can happen years after treatment.
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How likely is recurrence?
Surgical excision alone recurs in more than half of cases. Excision plus adjuvant superficial radiotherapy given within 24 hours drops recurrence below 15% in most series. Excision plus a monthly intralesional steroid programme for six months gives recurrence rates of 20 to 40%. Earlobe keloids treated with excision, pressure earrings and steroid injections recur in 10 to 30%.
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Is keloid treatment covered by private medical insurance?
Consultant dermatology or plastic surgery assessment is often covered when the keloid is symptomatic (itchy, painful, restricting movement). Intralesional injections and surgical excision may be reimbursed with pre-authorisation. Adjuvant superficial radiotherapy and laser sessions are frequently self-pay or partially covered. We check your policy before you book.
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Can I still get my ears pierced if I have had a keloid?
Anyone who has grown one keloid is at high risk of growing another after further trauma. If you choose to re-pierce, do it once the original keloid is stable, use hypoallergenic titanium studs, apply silicone gel from day one and wear pressure earrings for three to six months. Discuss it with your dermatologist first.
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Is superficial radiotherapy safe for keloids?
Adjuvant superficial radiotherapy for keloids uses a low total dose (typically 12 to 15 Gy in three fractions) delivered to a small, defined field. The lifetime risk of radiation-induced malignancy is very low but not zero, so it is avoided over the thyroid, breast tissue in young women and in children. Your consultant will discuss risk and benefit in detail.
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Will my skin colour match after treatment?
Keloids are more common in darker skin phototypes, where post-inflammatory hyperpigmentation and hypopigmentation after treatment are real risks. Pulsed-dye and fractional lasers can improve residual redness and texture. Camouflage make-up and gentle exfoliation can help colour blend during healing. Full colour normalisation can take 12 to 24 months.
Ready when you are
Consultant-led keloid care in London.
Send us a short brief. We come back within one working day with a matched consultant, an indicative price and the next available slot.