Keloid Treatment in Gurgaon

A keloid is scar tissue that keeps growing after a wound has closed, spreading beyond the original injury as a firm, raised, often itchy or tender lump. Keloid treatment at Dr. Shikha Bansal’s clinic in Gurgaon is planned as a course rather than a single procedure - an intralesional injection series is the mainstay, with surgical excision added for bulky or stalked lesions and post-operative injections running afterwards. That matters because a keloid genuinely relapses: excision on its own recurs in a large share of published cases, while excision paired with an injection series does considerably better.

What a keloid is, and how it differs from an ordinary scar

A keloid is an overgrowth of scar tissue in which the healing response does not switch off. The defining feature is the border: a keloid extends beyond the boundary of the original injury into surrounding normal skin, while a hypertrophic scar stays inside it and often flattens on its own over 12 to 18 months.

The typical appearance is a firm, rubbery, shiny lump, darker or redder than the skin around it, sometimes stalked. Symptoms matter as much as looks: itching is very common, tenderness or burning is frequent, and a keloid over a shoulder or joint can catch on clothing or restrict movement. Keloids tend to appear one to twelve months after the injury, often once the site already looked healed, and they rarely, if ever, regress on their own.

Why keloids form - causes and risk factors

• Genetic predisposition - a first-degree relative with keloids is one of the strongest predictors, alongside skin tone and site, and keloids are several times more common in deeper skin tones, which is why they are seen so often in Indian practice.
• Ear and body piercings - especially gun piercings that crush rather than cut, and cartilage piercings in the upper ear.
• Acne, folliculitis, and chickenpox - inflammatory lesions on the chest, jawline, and back that heal into raised scars.
• Burns, lacerations, and surgical incisions, including scars from procedures done elsewhere.
• High-tension sites - the chest, shoulders, upper back, and jawline carry the most mechanical tension and the highest keloid rates. The ear lobe is a low-tension site, but lobe keloids are common simply because piercing is common. The palms, soles, and eyelids almost never keloid.
• Age 10 to 30, and hormonal phases such as puberty and pregnancy, when keloid formation peaks.
• Repeated irritation of a healing wound - infection, snagging jewellery, or picking, all of which prolong inflammation.

Keloid treatment options - what is used, and when

There is no single best treatment. The plan depends on size, thickness, site, whether cartilage is involved, and how the lesion responded to anything tried before.

Intralesional corticosteroid injection is first-line for most small-to-moderate keloids and the mainstay of treatment here. Dilute triamcinolone is injected into the lesion to suppress the fibroblasts driving growth, slow new collagen production, and speed breakdown of the collagen already laid down. Sessions typically run every four to six weeks, commonly three to six of them, and softening usually arrives before visible flattening. The recognised side effects are hypopigmentation, which can be long-lasting and is more noticeable on deeper skin tones; thinning of skin and fat that can leave a small depression; visible fine vessels at the site; and occasional ulceration. That is why dosing is kept conservative.

5-fluorouracil and bleomycin are the usual second injectable lines when a steroid course stalls - 5-fluorouracil, alone or mixed with triamcinolone, more often than bleomycin. Both are used off-label for keloids, on a smaller evidence base than steroid. Injection pain, ulceration, and hyperpigmentation are recognised effects, and bleomycin can cause dermal necrosis and a streaky pigmentation pattern. Neither is offered in pregnancy or while breastfeeding, and bleomycin is avoided on the fingers and toes.

Surgical excision is for bulky or stalked keloids and lesions injections cannot flatten, and is always planned with a post-operative injection series rather than performed on its own.

Two things are worth stating plainly, because patients ask about both by name. Cryotherapy and laser are not part of the course offered at this clinic - the plan here is injection-led, with excision where the lesion needs it. Superficial radiotherapy is a specialist, last-line adjuvant, referred out to a radiation oncology unit rather than delivered here. It is reserved for resistant or repeatedly recurrent lesions because of the small long-term risk from irradiating normal skin, and is not used in children or in pregnancy.

Which rung a particular keloid starts on is decided at examination, and the grouping below is roughly how cases sort out in practice.

• Injections first, no surgery - soft, low-to-moderately raised lesions, still reddish and active, and not treated before. Most fresh ear lobe and acne keloids sit here.
• Excision with a planned post-operative injection series - bulky, stalked or pedunculated lesions, anything that has not measurably flattened after three or four injection sittings, and keloids catching on clothing or limiting a joint.
• Excision, an injection series, and a radiotherapy opinion elsewhere - keloids that have already recurred after excision, and large lesions at high-tension sites.
• Staged and treated more cautiously - cartilage keloids of the upper ear, and chest, shoulder, upper back and jawline keloids, where recurrence rates run higher and closure sits under tension. Lobe keloids tend to do better than chest keloids for the same reason. The site-by-site differences are set out in the guide to surgery for keloids by site.
• Settled before any cosmetic plan - an infected, ulcerated or bleeding lesion, and any lump whose diagnosis is not certain, which is biopsied first.

Surgery for keloids - what a keloid operation involves, step by step

Consultation and assessment. The lesion is examined, measured, and photographed, and its history taken - how long it has been there, what has been tried, whether it recurred after a previous keloid surgery removal elsewhere. Family history, skin type, active infection, blood thinner use, and pregnancy are recorded. A keloid still actively enlarging is usually settled with injections first.

Planning. Excision lines are marked so the scar sits along a relaxed skin tension line wherever the site allows, and the post-operative injection schedule - how many sittings, and at what intervals - is written down before consent.

Excision under local anaesthesia. Lignocaine with adrenaline is infiltrated around the lesion. Once the area is numb the keloid is excised and the wound closed in layers, so tension sits on the deep layer rather than the skin edge. Most ear lobe and small body keloids take 30 to 60 minutes; larger or multiple lesions take longer and may be staged.

Same-day discharge. The patient goes home the same day with a dressing, and the excised tissue is sent for histopathology.

Before a keloid excision, and recovery afterwards

Before the procedure. Blood thinners, aspirin, and supplements such as fish oil or vitamin E are reviewed about a week ahead and stopped only on medical advice. Active infection at the site is treated first. Stopping smoking helps, because nicotine narrows the small vessels a healing wound depends on. The area is left unwaxed on the day, the patient eats normally for a local-anaesthetic case, and anyone already on an injection course is told which sitting the excision replaces.

Recovery from the wound itself is short, but an excision is still surgery and carries the usual risks: bleeding or a collection under the wound, infection, delayed healing or partial separation of the wound edges, and darkening or lightening of the skin around the scar. On the ear lobe the contour can also end up slightly altered. These are uncommon with a small day-care excision and are discussed before consent rather than afterwards.

The part that decides the result is the injection phase that runs for months afterwards, so the whole timeline is written down at consultation rather than described visit by visit.

• Day 0 to day 2 - the dressing stays dry and intact. Mild soreness is usual and generally settles with paracetamol, and the site is kept still rather than stretched.
• Day 3 to day 7 - desk work is comfortable for most patients. The wound is checked and the dressing changed. Sweating, swimming, and gym work wait.
• Day 7 to day 14 - sutures are removed and the healed wound is checked before the injection schedule resumes.
• Week 2 to week 6 - the first post-operative intralesional injection is given, then repeated at roughly four-to-six-week intervals for the planned number of sittings.
• Month 2 to month 6 - the injection course continues to its planned end. This is the phase patients most often abandon, and it is the phase that tends to decide whether the scar stays flat.
• Month 6 to month 12 - the scar is reviewed with photographs and measurements. Early thickening is injected promptly rather than watched, because a small recurrence responds far better than a re-established keloid.
• After month 12 - a keloid can still recur after the first year, sometimes years later. New itching, firmness, or thickening at the site is worth having reviewed promptly rather than watched, for the same reason as above.

Why excision alone recurs, and what keloid permanent treatment honestly means

Surgery on a keloid is a fresh wound in tissue that has already proven it over-heals. That is why excision on its own is the weakest way to treat a keloid: recurrence after isolated excision is reported across published series at roughly 45 to 100 per cent, and higher again for lesions that had already recurred once. Quoting the operation without the protocol that follows it is the commonest reason patients end up with a keloid larger than the one they started with.

Excision followed by an intralesional steroid series at set intervals brings reported recurrence down to roughly 10 to 50 per cent in published series, and superficial radiotherapy lowers it further in resistant cases where it is available. Figures vary with site, size, skin type, and how consistently the injection course is completed, so they are discussed as ranges rather than promises.

That is also the honest answer on treating a keloid permanently. A keloid can be removed, and many stay flat once the injection course is completed - but keloid tendency belongs to the person’s healing rather than to the lump, so a recurrence can still appear months or even years later, and no surgeon can promise it will never return.

Ear lobe keloid after piercing - the commonest presentation

Most keloids seen at the clinic sit on an ear lobe after a piercing - usually a gun piercing in the teens or twenties, a site that looked healed, then a firm bead that grows until earrings no longer sit properly.

Lobe keloids respond comparatively well, because the lobe is a low-tension site and the lesions are usually small when patients present. A course of intralesional steroid flattens a good proportion of small-to-moderate lobe keloids. Bulky or stalked ones are excised, with the injection schedule resuming once the wound has closed. Where the lobe is also split or elongated, keloid excision and surgical ear lobe repair are done in the same sitting.

Re-piercing is possible for some patients but never during active treatment. Where it is considered, the site should have been flat and stable for six to twelve months, pierced with a needle rather than a gun, and worn only with light studs. Even then, re-piercing carries a real risk of the keloid returning, and some patients are advised against it altogether. The staged ladder, the home remedies that do not work, and the re-piercing decision are covered in the guide to a cure for keloids on the ear after piercing. Cartilage keloids higher up the ear are treated more cautiously, because recurrence rates run higher there and ear shape has to be protected - the same discipline used in ear reshaping surgery.

Keloid laser removal - why it is not the plan here

Keloid laser removal is one of the most searched options and one of the most over-promised, so it is worth answering directly: laser is not part of keloid treatment at this clinic. That is a deliberate choice rather than a gap.

What laser can do is limited. Pulsed-dye laser targets the vessels feeding an active keloid and tends to help with redness and itching across several sessions; fractional resurfacing improves texture in a scar that is already flat. What laser does not reliably do is remove bulk. Ablative laser removal behaves much like surgical excision - still a wound in keloid-prone tissue, carrying much the same recurrence risk, and still needing an injection course afterwards. A patient asking for laser on a thick, raised keloid is told plainly that laser alone tends not to debulk it, and is offered the injection-led course instead.

Prevention, when to see a doctor, and consulting in Gurgaon

Anyone with a personal or family history of keloids is worth counselling before an elective piercing or any planned surgery - needle rather than gun piercing, fewer sites, avoiding high-tension areas such as the chest and shoulders, and having a new wound reviewed early rather than waiting for a lump to establish itself.

A lump behaving predictably can wait for a routine appointment. Examination sooner is sensible for rapid growth over a few weeks, bleeding, ulceration or discharge, pain out of proportion to the lesion, spreading redness, a change in colour or firmness, a raised scar still unsettled at 18 months, or regrowth after previous treatment.

Consultations are with Dr. Shikha Bansal, plastic and reconstructive surgeon: MBBS (Gold Medalist), MS General Surgery, MCh Plastic & Reconstructive Surgery (SMS Medical College, Jaipur, 2022), Haryana Medical Council Reg. No. 24859. The clinic is in Sushant Lok 1, Gurgaon. Call or WhatsApp the clinic, or book a consultation using the form on this page.