How Does Kenalog Work? Does It Actually Destroy Collagen?

I am sorry that you have developed Keloid scars. Besides being unsightly, they can itch and burn. Kenalog injection can decrease inflammation and do not directly affect collagen. The improvement in the appearance of the scar is variable, but this usually helps with symptoms of itching and burning. Unfortunately, there are also side effects like you mentioned. Other options are silicone sheeting and surgical excision. The problem with surgical excision is that it can back, and maybe even worse.  Radiation treatments have been used, as have electrical impulses in the scar.  One very new option is treatment with a product called ACell. This is regenerative matrix that can help to stimulate growth of normal scar (as opposed to a keloid) when combined with surgical excision.  I have had some promising results with this but the product can be expensive and will not be covered by insurance.

If the Kenalog did not work, then you may consider a revision if a year has passed, and perhaps a different suture to be used.  Ethnic skin can increase your chances of a large scar so this is a factor is you revise the scar again.