Keloid scar on chest - how can I reduce and flatten this scar? (Photo)

Question

I am writing to inquire about treatment options for a keloid scar on my chest. My main goal is to reduce and flatten the scar, as it is raised and has been persistent for some time. I would appreciate your advice on the most effective treatments available, particularly options such as steroid injections or combination therapies, and whether these would be suitable in my case. Please also let me know what the usual treatment process involves and if a consultation would be required beforehand. Thank you very much for your time and assistance. I look forward to your guidance. Kind regards,

Anna Chacon, MD, FAAD · Answer

Keloid scars can be incredibly frustrating. They often feel firm, raised, and can continue to grow beyond the edges of the original injury. The chest is one of the most common areas for keloids to develop, and unfortunately, they also tend to be more stubborn there. From your description and the appearance of the scar, this looks consistent with a mature keloid rather than a simple hypertrophic scar.

Keloids form because the skin’s healing response becomes overactive, producing excess collagen. Once established, they usually don’t flatten or fade on their own, which is why treatment is often needed if the goal is to reduce bulk and improve comfort and appearance.

One of the most effective first-line treatments is intralesional corticosteroid injections. These are small amounts of steroid medication placed directly into the scar tissue. Over a series of sessions, this can help soften the keloid, reduce thickness, and make it flatter. Many people notice gradual improvement after a few treatments, but keloids typically require repeated sessions spaced several weeks apart to get the best result.

For thicker or more resistant keloids, combination therapy often works better than a single approach. This can include:

Steroid injections combined with medications such as 5-fluorouracil to further reduce scar tissue

Cryotherapy (controlled freezing) to shrink the bulkier portions

Laser treatments to improve texture and color

Silicone gel or silicone sheets applied regularly at home to help maintain flattening between treatments

Surgical removal alone is usually not recommended for keloids on the chest because they have a high chance of coming back, sometimes even larger than before. If surgery is ever considered, it is typically paired with immediate post-procedure treatments (such as steroid injections or radiation in select cases) to lower the risk of recurrence.

The usual treatment process is gradual rather than one-time. Most plans involve a series of in-office treatments over a few months, with ongoing maintenance as needed. The goal is realistic improvement: flattening the scar, softening it, and making it less noticeable, rather than completely erasing it.

Because keloids can behave differently from person to person, an in-person assessment is important before starting any therapy. This allows the thickness, firmness, and activity of the scar to be evaluated so that the treatment intensity and combination can be tailored appropriately.

While keloids can be persistent, many patients do achieve meaningful flattening and softening with consistent, combination-based care.

Keloid scar on chest - how can I reduce and flatten this scar? (Photo)

Answers (1)

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