Keloids: What They Are, How We Treat Them, and Why SRT Is a Game Changer

If you have ever had a scar grow bigger, thicker, or itchier than it should, you may be dealing with a keloid. Keloids are common, they can be frustrating, and the good news is that they are very treatable, especially when caught early and managed with the right combination of therapies. Here is what you need to know about keloids and how our practice uses Superficial Radiation Therapy, or SRT, to keep them from coming back.

What Is a Keloid?

A keloid is a type of raised scar that forms when your skin overproduces collagen while healing from an injury. Normal scars stay within the boundaries of the original wound and gradually flatten and fade. Keloids do the opposite. They grow beyond the edges of the original injury, sometimes years after the initial wound has healed, and they tend to stay raised, thick, and discolored rather than settling down over time.

Keloids can form after almost any kind of skin trauma, including surgical incisions, acne, ear piercings, burns, insect bites, vaccinations, or even a minor scratch. Some people are simply more prone to them than others. Genetics plays a big role, and people with darker skin tones, including those of African, Hispanic, and Asian descent, are statistically more likely to develop keloids. If you have a family history of keloids or have developed one before, your risk of forming another is higher.

Keloids are not dangerous or cancerous, but they can be uncomfortable both physically and emotionally. They are often itchy, tender, or even painful, and depending on their size and location, they can affect how you feel about your appearance. This is especially true when they form on visible areas like the ears, chest, shoulders, or jawline.

How Keloids Are Treated

There is no single treatment that works for every keloid, which is why we take a personalized approach based on the size, location, and history of each scar. Common treatment options include:

Corticosteroid injections, which help flatten the scar and reduce inflammation, itching, and pain. These are often used as a first line treatment for smaller keloids or as a follow up after other procedures.

Cryotherapy, which freezes the keloid tissue to help shrink it. This works best on smaller keloids and is sometimes combined with steroid injections for better results.

Laser therapy, which can reduce redness, flatten the scar, and improve its texture and color over a series of sessions.

Silicone sheeting and pressure therapy, which are non invasive options that can help manage smaller or newer keloids, particularly after a procedure.

Surgical excision, which physically removes the keloid. This is often the most effective way to reduce the size of a large or long standing keloid.

Here is the catch with surgery alone: keloids have a well earned reputation for coming back, and they often come back larger than before. Studies show that surgical excision by itself carries a recurrence rate of up to 70 percent. That statistic used to make excision a risky option on its own. This is exactly where Superficial Radiation Therapy has changed the game.

How We Use SRT to Treat Keloids

Superficial Radiation Therapy, or SRT, is a low dose, targeted form of radiation that we use immediately following surgical removal of a keloid. Instead of relying on excision alone and hoping the keloid does not return, we follow up with a short course of SRT treatments, typically administered on consecutive days within about a week of the surgery.

SRT works by targeting the fibroblast activity in the skin that causes keloids to overproduce collagen in the first place. By treating the site right after excision, we interrupt that overactive healing response before it has a chance to form another keloid.

The results speak for themselves. Research shows that when SRT is used after surgical excision, recurrence rates drop dramatically, from around 70 percent with surgery alone down to roughly 10 to 13 percent within the first year and a half. Long term data even shows cure rates in the mid 80 percent range from two years out. That is a significant difference for anyone who has already dealt with a stubborn keloid once and does not want to go through it again.

SRT is quick, painless, and done right in our office with no downtime. Most patients tolerate it very well. The most common side effect is temporary darkening of the skin at the treatment site, which typically resolves on its own. Because the radiation is superficial and highly targeted, it does not affect deeper tissue or other areas of the body.

Is SRT Right for You?

SRT following excision tends to work best for keloids that are large, have returned after previous treatment, or are in a location prone to recurrence, such as the chest, shoulders, or earlobes. During a consultation, we will look at your specific keloid, your history, and your skin type to determine whether a combination of excision and SRT, or another treatment path entirely, is the best fit for you.

If you have a keloid that has been bothering you, whether it is new or one that keeps coming back no matter what you try, you do not have to live with it. Our team has experience combining the latest evidence based treatments, including SRT, to give you the best possible outcome with the lowest chance of recurrence.

Give us a call at (520) 382-3330 or press Book Now to schedule a consultation with our dermatology team. Let's get your skin, and your confidence, back to where it should be.

Happy Skin, Happy Life!