Keloid Treatment: A Clinical Guide to Understanding Options, Limitations, and Assessment

A keloid is a scar that grows beyond the edges of the original wound. It is neither an infection nor a malignant tumor, but it can cause discomfort due to its size, tightness, itching, pain, or the appearance of the skin. There is no one-size-fits-all treatment for keloids: it depends on the location, how long it has been present, whether it has been treated before, and the individual’s tendency toward excessive scarring.

This guide, prepared by Mallorca Medical Group in Palma de Mallorca, summarizes current guidelines for plastic and reconstructive surgery. The goal is not to promise that scars will disappear, but rather to explain what can be assessed, what should not be done on a whim, and why treatment decisions must be tailored to each individual.

What is a keloid, and how does it differ from a hypertrophic scar?

Every skin wound heals. In some people, the healing process goes too far, and the scar becomes raised, hardened, and red. The most useful clinical distinction is the border of the lesion:

• Hypertrophic scar: remains within the edges of the wound. It usually improves, at least partially, over time and with conservative treatment.
• Keloid: invades healthy skin around the wound. It can grow for months or years and recur if left untreated without a management plan.

Keloids are most common on the earlobe, shoulder, neckline, back, and sternum. They can also develop after acne, vaccinations, piercings, burns, or surgery. Family history and certain skin types increase the risk, but they do not alone determine the outcome of treatment.

Before discussing reconstructive surgery in Mallorca or any other technique, it is important to confirm the diagnosis. A lesion that grows rapidly, bleeds, changes color, or does not resemble a previous scar should be evaluated to rule out other skin conditions.

When Does It Make Sense to Treat, and When Is It Better to Monitor?

Not every small, stable keloid requires treatment. Treatment is considered when there are symptoms, growth, limited movement, or a clear impact on daily life. For recent scars, follow-up, sun protection, and topical treatments over several months are sometimes sufficient.

The personalized assessment reviews:

• How long the scar has been present and whether it is still growing.
• Symptoms: itching, pain, tightness, or a previous local infection.
• Anatomical location and skin tension.
• Previous treatments and how the scar responded.
• Realistic expectations: to improve volume and symptoms, not to erase the history of the wound.

During the initial plastic surgery consultation, a definitive treatment plan is not decided upon without first examining the lesion. Request a personalized evaluation if the scar changes, is painful, or has already recurred after a previous treatment attempt.

Treatment Options: From Conservative Management to Surgery

The standard approach combines various measures, not a single technique. The literature and guidelines on pathological scarring—including reviews compiled by the National Library of Medicine and documents from plastic surgery societies—identify corticosteroid injections, pressure therapy, and silicone as the foundation of treatment, reserving surgery for selected cases.

Isolated resection—without infiltrations, silicone, compression therapy, or, in select cases, superficial radiation therapy coordinated with an accredited facility—is not a prudent strategy. The keloid may reappear larger than the original scar. For this reason, the plastic surgeon plans the closure with as little tension as possible and ensures that follow-up care is properly organized.

A keloid is not treated like just any scar. If it is excised without a plan to control scar formation, there is a real risk of recurrence. The treatment approach is determined on a case-by-case basis, not according to a generic protocol.

Safety, instructions, and what not to promise

No treatment for keloids is risk-free, nor does it produce the same results in everyone. Repeated use of corticosteroids can lighten or thin the skin. Laser treatment can cause hyperpigmentation if the skin is not protected from the sun. Surgery leaves a new scar—albeit one that is more controlled—and requires follow-up visits.

At Mallorca Medical Group, safety is based on medical necessity, not commercial urgency. Dr. García Ceballos, FCCP—who trained in plastic surgery at the UZ VUB in Brussels and is a member of the Royal College of Surgeons (MRCS I England)—assesses whether a lesion requires medical treatment, reconstructive surgery, or observation. Clinical experience—25 years of practice as of 2026—is no substitute for examining each scar individually.

You should be wary of messages that promise permanent removal, the absence of risks, or a fixed price without having examined the injury. The cost of plastic surgery in Mallorca, when surgery is indicated, depends on the size of the area, the location, whether an operating room is required, and the follow-up plan. The estimate is prepared after the evaluation, not before.

What to Expect After Treatment

Improvement, when it occurs, is gradual. Injections are spaced out over weeks. Silicone therapy and compression therapy are continued for months. After a resection, the first few weeks are devoted to protecting the wound, limiting tension, and monitoring for redness.

Signs that require immediate medical attention, even before your scheduled follow-up appointment: rapid increase in swelling, discharge, fever, disproportionate pain, or a scar that has opened up. Postoperative follow-up is part of the treatment; it is not an afterthought.

Opinions about www.mallorcamedicalgroup.com do not predict how a specific scar will respond. Each patient is a unique case.

Conclusion

In Palma de Mallorca, Mallorca Medical Group views this issue as a matter of reconstructive surgery, not as part of a cosmetic medicine catalog. Choosing a reputable plastic surgery clinic in Spain involves considering the surgeon’s qualifications, professional certification, and willingness to explain when surgery is not the right option.

A keloid is a scar that invades healthy skin and may recur. Treatment combines conservative measures and, only in select cases, surgery with a prevention plan. There is no technique that guarantees complete resolution. What can be done, however, is to provide a clear diagnosis, prudent treatment recommendations, and follow-up care that reduces the risk of the lesion regrowing.

Book your consultation at mallorcamedicalgroup.com or request a personalized medical consultation at Mallorca Medical Group, Camí Vileta 46C, Palma de Mallorca.

Frequently Asked Questions

Does a keloid go away on its own?

This is not typical. Unlike some hypertrophic scars, keloids tend to remain stable or grow. They may stabilize, but one should not assume they will resolve on their own without an evaluation.

Can a keloid be surgically removed?

Yes, for certain types of injuries, provided there is always a plan to manage subsequent scarring. Performing surgery and doing nothing else increases the risk of recurrence, sometimes resulting in a larger scar.

Do injections replace surgery?

For many small or moderate keloids, this is the first step. It does not replace surgery when the size, tension, or recurrence of the keloid warrants it. The treatment plan and number of sessions are determined during the consultation.

Does the treatment hurt or make your skin worse?

Injections cause temporary local discomfort. Repeated corticosteroid injections can thin or lighten the skin. For this reason, they should not be administered indefinitely or without medical supervision. The goal is to improve symptoms and restore volume, not to promise scar-free skin.

Dr. García Ceballos, FCCP
Plastic, Aesthetic, and Reconstructive Surgery · MD · FCCP · MRCS (England)
Mallorca Medical Group · Palma de Mallorca
mallorcamedicalgroup.com