What should you know about scalp keloid treatment?

A keloid is a raised scar made from extra scar tissue. It can extend beyond the original injury, such as a cut, piercing, inflamed hair follicle, or other skin irritation. On the scalp it may feel firm, itchy, tender, or tight, and hair may be difficult to trim around it. A clinician may examine its shape, surface, colour, growth pattern, and any history of injury before confirming the diagnosis. Other skin lumps can look similar, so avoid squeezing, cutting, or repeatedly scratching an undiagnosed lump.

Treatment usually improves the scar rather than restoring completely uninjured skin. The plan depends on whether the keloid is active or stable, whether it is painful or itchy, its location and size, and whether it has returned after earlier treatment.

Arrange a dermatology assessment, especially if the raised area is enlarging, repeatedly irritated by shaving, or affecting sleep or comfort. Common options include steroid injected into the scar to calm excess scar activity; laser treatment to address colour, texture, or thickness; and cryotherapy, which freezes selected scar tissue. A clinician may recommend more than one approach and several visits.

Surgical removal may be considered when a keloid is bulky or restricts daily care, but removing it alone can be followed by regrowth. Ask how recurrence prevention will be planned after the procedure. Keep the area clean, protect healing skin from friction and sun, and follow wound-care instructions. Do not apply home acids or attempt to drain the lump.

Book a prompt appointment for a lump that is growing, bleeding, ulcerated, newly painful, or changing in colour or surface. Seek urgent medical help if the scalp becomes rapidly swollen and hot, pain becomes severe, or you develop fever, spreading redness, or drainage. These features may point to infection or another problem rather than a settled scar.

If a treated area opens, becomes increasingly tender, or produces discharge, contact the treating clinic for wound advice. A new lump after an injury should be assessed before treatment is chosen; a skin-lump guide can help you prepare for that discussion.

Ask: How confident are you that this is a keloid? Which feature of my scalp lesion makes you choose injections, laser, freezing, or surgery? How many appointments might the plan involve? What wound care is needed around hair washing and trimming? How will you monitor for regrowth, and what should I do if itching, pain, bleeding, or drainage develops?