What should you know about a flattened keloid?

Keloids are scars that extend beyond the original wound and continue making dense collagen. Treatment or natural change may reduce their height without removing all of the scar. The area may remain darker, lighter, shiny, tight, or uneven compared with nearby skin. A keloid can follow acne, piercing, surgery, an injection, or a minor injury; an acne history may be relevant when discussing [Acne](/conditions/acne/). A new or changing skin lump should be assessed rather than labelled from appearance alone; see [Skin Lumps](/symptoms/skin-lumps/) for general context.

Arrange a dermatology assessment if the scar is growing, uncomfortable, or affecting movement. The clinician may compare photographs, examine its edges, and ask how it developed. Options can include [Steroid Injection Into The Skin](/treatments/injectables/intralesional-steroid-injection/), laser approaches such as [Fractional Laser Treatment](/treatments/laser-and-energy/fractional-laser-treatment/) or [Pulsed Dye Laser Treatment](/treatments/laser-and-energy/pulsed-dye-laser-treatment/), and selected procedures. Cryotherapy may be discussed for suitable lesions; learn about [Cryotherapy (Lesion Removal)](/treatments/surgical-dermatology/cryotherapy-lesion-removal/). Do not pick, scratch, or repeatedly rub the area, and protect it from sun exposure so colour change is less noticeable.

Seek prompt medical review if the scar rapidly enlarges, bleeds, ulcerates, becomes hot and increasingly painful, drains fluid, or develops marked redness. Arrange review sooner if it restricts a joint, eyelid, ear, or another body opening. A clinician may need to distinguish a keloid from another growth before choosing treatment. Surgery can be considered in selected cases, including [Keloid Removal Surgery](/treatments/surgical-dermatology/keloid-excision/), but recurrence prevention should be part of that discussion.

Ask whether the scar is consistent with a keloid, whether its current flattening suggests treatment response, and which option fits its site and thickness. Discuss the chance of colour change, wound-care needs, recurrence, and how long improvement may take. If surgery is suggested, ask why [Surgical Excision](/treatments/surgical-dermatology/excisional-surgery/) is appropriate and what follow-up will be needed.