Keloids are more than a cosmetic concern — they itch, ache, feel tight, and take a lasting psychological toll. Unlike ordinary scars, they don't fade with time. But with a properly administered intralesional corticosteroid protocol, over 70% of keloids can be flattened and controlled effectively — no surgery needed.

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Keloid Injection Treatment in Da Nang — Non-Surgical Keloid & Hypertrophic Scar Reduction at Foxy M.D Clinic

What Are Keloids? Why Are They So Difficult to Treat?

Keloids form when the wound-healing process loses control — fibroblasts continue producing collagen long after the wound has closed, creating raised scar tissue that extends beyond the original wound boundary. Unlike hypertrophic scars (which stay within the wound margins and may self-improve), keloids do not regress and typically continue growing.

Common locations: ears (after piercing), chest, shoulders, abdomen after surgery, chin, upper back. People with darker skin tones (Fitzpatrick IV–VI) have a significantly higher risk of keloid formation.

Keloids are difficult to treat due to their genetic basis and chronic local inflammation. Surgical excision alone carries a 45–100% recurrence rate — which is precisely why intralesional corticosteroid injection is considered the first-line or mandatory combination treatment.

How Does Intralesional Corticosteroid Injection Work?

Triamcinolone acetonide (TAC) is injected directly into the scar tissue at concentrations of 10–40 mg/ml depending on severity. Once inside the scar tissue, TAC acts through multiple mechanisms:

• Collagen synthesis inhibition — reduces fibroblast activity and limits excessive collagen production
• Enhanced collagen breakdown — activates collagenase to break down accumulated collagen fibres in the scar
• Chronic inflammation reduction — suppresses pro-inflammatory cytokines (IL-1, TNF-α) that sustain abnormal scar formation
• Reduced blood supply — causes vasoconstriction in the scar's microvasculature, limiting nutrient supply to growing scar tissue

Result: the scar progressively flattens, softens, lightens in colour, and reduces in itchiness and pain with each session.

Who Is a Good Candidate / What to Be Aware Of?

✅ Suitable for:

• Newly formed keloids (under 2 years old) — best treatment response
• Small to medium keloids on the ear, chest, shoulder, or chin
• Hypertrophic scars from surgery or trauma
• Prevention of recurrence after surgical scar excision
• Those who prefer non-surgical management

⚠️ Notes and cautions:

• Very large keloids — often require combination: surgery + injection + compression or laser
• Pregnancy — requires careful consideration and physician advice
• Active infection in the scar area
• Overly superficial injection or excessive dosing can cause skin atrophy — an experienced dermatologist is essential

7-Step Keloid Injection Procedure at Foxy M.D

1. Consultation & scar classification — dermatologist distinguishes keloid from hypertrophic scar, assesses size, firmness, scar age, and treatment history
2. Treatment plan — determines TAC concentration, number of injection points, and session intervals
3. Cleansing & antiseptic preparation — the scar area is cleaned before injection
4. Topical anesthetic if needed — especially for sensitive scars or thin-skinned areas
5. Intralesional corticosteroid injection — TAC injected directly into scar tissue at the correct layer with even distribution
6. Immediate response monitoring — patient observed for 10–15 minutes post-injection
7. Aftercare & follow-up — gentle scar massage after 24h, progress monitoring, next session in 4–6 weeks

❓ Frequently Asked Questions

❓ Is the injection painful?
Yes — injecting into dense scar tissue requires higher pressure than normal skin. The dermatologist may apply topical anesthetic beforehand or dilute the medication with lidocaine to reduce discomfort. Mild aching for a few hours post-injection is normal.

❓ How many sessions until the scar flattens?
Hypertrophic scars typically respond within 2–4 sessions. Keloids require 4–6 or more sessions. Sessions are spaced 4–6 weeks apart to assess response and adjust dosage.

❓ Can the scar come back after flattening?
Keloids do carry a recurrence risk, especially in those with a strong scarring tendency. Once flat, maintenance injections every 3–6 months plus silicone sheets can help sustain results.

❓ Can the injection cause skin atrophy?
Skin atrophy is a possible side effect if the injection is too superficial or the dose too high. This is a key reason to choose an experienced dermatologist — correct layer placement and concentration are critical.

❓ Is combination treatment ever needed?
For large or recurrent keloids, the dermatologist may recommend combining injection with laser (Nd:YAG or pulsed dye laser), silicone sheets, and compression. Combination protocols achieve significantly better outcomes than monotherapy.

Conclusion

Intralesional corticosteroid injection is the most scientifically validated treatment for keloids and hypertrophic scars, recommended as first-line therapy by the world's two leading dermatology associations. At 399,000–999,000 VND per session at Foxy M.D, it offers a cost-effective and clinically proven approach for most keloid and hypertrophic scar cases.

One important note: not every raised lesion on the skin is a keloid — accurate diagnosis by a dermatologist before treatment is essential. Book a consultation to get the right protocol from the very first step.