How effective is steroid injection into the skin for keloid scars?

An intralesional steroid is delivered directly into the thickened scar rather than spread over the surrounding skin. It can reduce the activity that keeps keloid tissue raised and firm. As the scar responds, it may become flatter, softer, paler, less tight, and less itchy or painful. A long-standing or bulky keloid may respond differently from a newer, smaller one, and the amount and depth of scar tissue affect the plan.

Improvement is usually assessed over a series of appointments, because one injection may not change the scar enough. Keloids can become active again after treatment, so a dermatologist may discuss maintenance or a combined plan when steroid injections alone do not provide enough change.

Have the scar examined before treatment so a clinician can distinguish a keloid from another raised scar and check whether it is still growing. Mention previous scar reactions, skin infections, diabetes, medicines, and any steroid treatment you have received. The injection can sting, and the area may be sore or swollen briefly afterwards.

Follow the aftercare instructions for the treated site. Do not pick at crusting, and contact the clinic if redness, warmth, drainage, or pain is increasing rather than settling. Keep follow-up appointments so the response and the skin around the scar can be checked.

Seek prompt medical advice if the injection site becomes increasingly red, hot, swollen, or painful, or if it produces pus, opens, or you develop a fever. These changes can indicate infection or another treatment problem. Arrange a dermatology review if the keloid is rapidly enlarging, bleeding without being injured, ulcerating, or causing persistent pain or restricted movement.

Ask whether the scar has features of a keloid, what improvement is realistic for its size and location, how the injection will be given, and when response will be reviewed. You can also ask whether pressure therapy, silicone-based care, another procedure, or a combined approach would suit your scar, and how the clinician will limit steroid exposure to nearby healthy skin.