Is surgical excision of a keloid scar a good option?
Mar 18, 2025
Source: Cainiu Health
Dr. Liu Wenmin
Introduction
The effectiveness of surgical excision for keloids mainly depends on their size and location. Small, superficial keloids are ideally treated with surgery, which can reduce their size and soften their texture. However, for large, deep keloids or in individuals with a keloid-prone constitution, surgical treatment has limited effectiveness. Therefore, alternative treatments such as laser therapy or cryotherapy are recommended; these modalities work through different mechanisms to reduce scar tissue.
Generally speaking, keloid refers to a hypertrophic scar. Whether surgical excision of a keloid is advisable mainly depends on the size and location of the keloid. For small-sized and superficial keloids, surgical treatment is usually effective. However, for large-sized and deep-seated keloids, the effectiveness of surgical treatment may be less satisfactory. If symptoms are severe, timely medical consultation is recommended. Detailed analysis is as follows:
If the keloid is relatively small, is a superficial epidermal keloid or an isolated keloid that has not affected the dermis, and the individual is not someone with a predisposition to keloid formation, surgical treatment can often yield satisfactory results. Surgery can directly remove the keloid, thereby reducing the size of the scar and softening its texture.
However, if the keloid is large in size and classified as an old or dermal-layer keloid, and the individual is prone to keloid formation, the effectiveness of surgical treatment may be limited. Additionally, some individuals may not be suitable candidates for surgery, as it could increase the risk of pigment deposition, making the scar more difficult to eliminate. In such cases, alternative treatments such as laser therapy or cryotherapy (freezing therapy) may be considered. Laser therapy works by using light and heat to target and repair scar tissue, while cryotherapy involves freezing the skin with liquid nitrogen to repair scar tissue, helping to reduce pigmentation and diminish the scar.
It is recommended to first assess the severity and specific characteristics of the keloid before selecting an appropriate treatment method. Additionally, proper local care during the treatment period is important, including maintaining good hygiene and protecting the area from sun exposure.
