Keloid scars

A keloid is an abnormal overgrowth of scar tissue that extends beyond the original wound. This happens when fibroblasts — the cells that help repair skin after injury — stay active for too long, producing excess collagen and causing the scar to keep growing. Depending on its size and location, a keloid may cause discomfort, pain, itching, cosmetic concerns, or restrict movement. Keloids often grow back after surgery if no additional treatment is given.

Common sites include:

• Chest and sternum
• Shoulders and upper arms
• Earlobes
• Upper back
• Mandible and jawline

Common symptoms of keloid scars

People with keloids may notice:

• A thick, raised, or expanding scar
• Itchiness, sensitivity, or pain
• Tension or pulling across the surrounding skin
• Cosmetic impact or visible distortion
• Functional restriction (e.g., around the earlobe, jawline, or shoulder)

Without treatment, keloids may continue to grow.

Causes of keloid scars

Keloids form when the body’s healing process doesn’t switch off properly, causing:

• Scar-forming cells (fibroblasts) to stay overactive
• Too much collagen to build up
• Long-lasting inflammation

Risk factors include younger age, darker skin phototypes (IV–VI), positive family history, and wounds on high-tension sites.

Low-dose radiotherapy (LDRT) is a proven follow-up treatment for keloids. It uses much smaller doses of radiation than those used to treat cancer, helping to calm scar-forming cells, reduce collagen build-up, and lower the risk of the keloid returning after surgery.

Applying radiation within a few days of surgery greatly lowers the chance of the keloid returning. It’s one of the most proven and effective treatments for lasting control over scarring.

Radiotherapy can be particularly helpful for patients who:

• Have undergone surgical excision of a keloid
• Have recurrent or high-risk keloids
• Have keloids in areas prone to stretching or tension
• Experience pain, itchiness, or limited mobility
• Prefer to avoid steroid injections or reduce the risk of repeated surgeries

Radiotherapy may also be used after revision procedures, including shaving, excision, flap reconstruction, or earlobe repair.

What to expect

At Icon, we understand that starting a new treatment can feel overwhelming. We’ll guide you through each step, tailoring your treatment to your individual needs.

1. Consultation and planning

You will meet with a Radiation Oncologist to discuss the size, location, prior treatments, and optimal timing of adjuvant therapy. Coordination with your surgeon ensures treatment begins within 24–72 hours of excision.

2. Treatment delivery

Keloid radiation is short, precise, and painless. Treatment is delivered:

• As 3–5 outpatient sessions
• Using highly targeted superficial or electron beams
• With shielding customised to protect surrounding healthy tissue

Each session typically lasts a few minutes.

3. After treatment

You can return to normal activities immediately. Mild temporary redness or dryness may occur but usually settles quickly.