Keloid Removal Cost and Treatment Guide

Scars are a natural part of the healing process, but not everyone heals the same way. While many scars fade over time with proper care, keloid scars tend to worsen as the scar tissue continues to grow beyond the original boundary of the injury.¹

These thick, raised scars can cause physical discomfort, such as itching or pain and may also lead to emotional distress due to their appearance.² Keloid removal can help improve both physical well-being and self-confidence, but it's a challenging process because the body's impaired healing response can cause keloids to recur, especially after surgical removal. Combination therapies and removal techniques are often the most effective approach for managing keloids.³

This guide will walk you through some of the latest advancements in keloid removal, including their costs and tips to help prevent recurrence.

What Causes Keloids to Form?

Keloid scars can show up anywhere there is trauma to the skin. This can include surgical sites, piercings, acne, tattoos, insect bites, burns and cuts or scrapes. The scars develop due to disruptions in the healing process, where the body produces too much collagen, elastin and other proteins that make up the skin’s structure. There is also an increase in certain cells, like fibroblasts and mast cells, which contribute to the scar’s growth.⁴

Keloids are more common in individuals with darker skin tones, particularly those of African, Asian and Hispanic descent.⁴ The exact cause of keloids isn’t fully understood, but research suggests they form when the body’s normal healing process goes off track. Inflammation plays a key role: Certain molecules that promote inflammation can increase scarring, while lower levels of molecules that usually reduce inflammation may also contribute.⁵

What do keloid scars look and feel like?

Keloids are usually:⁴

• Firm or rubbery to the touch
• Pink, red, purple or darker than your surrounding skin
• Raised and thick
• Shiny and smooth on the surface

You might notice itching, tenderness or even pain. Sometimes, keloids can make it harder to move if they form over a joint. Treatment may be determined by the size and extent of keloid formation.³

What Is Keloid Removal?

The first step in removing keloids is to assess how severe the condition is and whether the keloids can be treated with less invasive methods.

For example, a small or moderately sized keloid or several small ones may respond well to conservative treatments. On the other hand, large, thick keloids or multiple keloids, especially if they appear in different areas of the body, often require more intensive treatments, such as surgery followed by radiation therapy and additional supportive measures.⁶

Types of keloid removal treatments

The integration of multiple treatments, such as surgery combined with corticosteroids or radiotherapy, is often employed for enhanced outcomes. Here are some of the most common surgical and non-surgical options for managing keloid scars:⁵

• Cryotherapy. This treatment involves freezing the keloid with liquid nitrogen to shrink and flatten it. It can be most effective for thinner or more recent keloids, but multiple sessions may be required.
• Intralesional corticosteroid injections. With this treatment, corticosteroids are injected into the keloid to reduce inflammation and size. This can be the most common non-surgical treatment for keloids. Timing, dosage and frequency of this treatment can vary.
• Keloid laser treatment. Lasers are used to target and reduce keloid tissue, improving texture and color. Lasers such as pulsed dye or CO2 flatten and reduce the keloid size. Keloid laser treatment is an effective keloid removal treatment. This treatment can be combined with steroid injections or silicone sheeting, and multiple sessions may be needed.
• Radiation. This treatment involves low-dose radiation applied post-surgery to prevent keloid recurrence. Low-dose radiation is used, and it can be an additional treatment after surgical excision.
• Surgical excision. Removal of the keloid through surgery, also called scar revision, is often combined with other treatments to prevent recurrence. This may be best for large keloids. They are removed under local or general anesthesia, and the surgical opening is closed with minimal tension to help reduce the chance of recurrence.

How Much Does Keloid Removal Cost?

The average cost for keloid removal and management may be as follows, and may vary depending on the number of sessions needed:⁶

Does Insurance Cover Keloid Removal?

Insurance coverage for keloid removal depends on whether your insurance company considers the treatment medically necessary or reconstructive rather than cosmetic.⁷

Medical policies, including those of government payers such as Medicaid, typically cover procedures to treat keloids when they cause symptoms, such as pain, infection and functional impairment, or when removal is part of reconstructive care following an injury.⁸ Work with your healthcare team to ensure you meet all of your preauthorization requirements.

How Does Keloid Removal Work?

Before starting treatment, it’s important to discuss the available options with your doctor and set realistic goals. The primary goals of treatment include reducing inflammation, restoring function, improving the appearance of the skin and preventing the keloids from coming back.³

What to expect from scar revision surgery

Certain areas of the body may require specific techniques for keloid treatment. For example, keloids on the earlobe can be removed with a wedge excision and primary closure. Keloids on the cartilage of the ear or on the fingers can be treated with core excision, where the central part of the keloid is removed while the surrounding tissue is preserved and then closed.³

Recovery and follow-up

Your surgeon may suggest low-dose radiation treatment after surgical removal. Surgery alone is usually not sufficient to prevent keloid recurrence. Radiation stops the formation of new blood vessels and keeps inflammation at bay during healing.³

After surgery, it's normal to experience some pain. You'll go home with prescription pain medications and instructions to care for your postoperative dressings. Your surgeon will want to see you in their office in about a week. Complete healing can take a year, but patients typically start to see improvements in six to eight weeks.⁹

After treatment, close follow-up is important. If there are signs of keloid recurrence, such as scar hardening, the use of steroid tape or plaster should be started immediately. In some cases, additional treatments like intralesional injections of triamcinolone or chemotherapeutic agents may be necessary.³

Consider All Your Options for Keloid Removal

Injections, piercings, acne or even surgical incisions can trigger keloid scarring. These scars are more prevalent in people with darker skin tones and can cause physical discomfort and psychological distress. There are several treatment options for keloid removal, each with its own benefits, costs and recovery times. Understanding the differences, costs and other factors can help you have a more informed discussion with your dermatology professional.

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Author Bio

Pamela Cagle, R.N., has extensive experience in a range of clinical settings, including ER, surgical and cardiovascular. For the past decade, she has leveraged her nursing experience in writing for health and technology publications such as AARP, VKTR, National Council on Aging and others. She is passionate about blending her medical and storytelling expertise to bring authenticity to health and wellness topics.