Southeast Asian woman in a sleeveless top with smooth shoulders and collarbones in soft side light, representing keloid and raised scar treatment at IN Eternity Clinic, Singapore

Keloids · Hypertrophic Scars · Raised Scars · Orchard Road

Keloid and Hypertrophic Scar Treatment Singapore

Name: Keloid and Hypertrophic Scar Treatment Singapore | IN Eternity
Creator: Dr Sin Yong
Published: 2026-10-17

Flattened and softened, with honest odds.

Raised scars are treated by type. At IN Eternity Clinic, Dr Sin Yong tells a keloid from a hypertrophic scar, then plans injections, silicone and selected laser, with referral when surgery plus an adjuvant is the better route.

WhatsApp to Enquire →Key facts ↓

2 types

Told apart first

Injection

First-line

Silicone

Prevention

Referral

When surgery fits

In short

A hypertrophic scar stays within the original wound and often softens over a year or two; a keloid grows beyond it and rarely settles alone. Both are usually treated first with steroid injections into the scar every four to six weeks, plus silicone gel or sheets, with laser for redness or texture once flattened. Keloid removal by excision alone often recurs, so it is combined with an adjuvant. Dr Sin Yong assesses which type you have.

Reviewed by Dr Sin Yong, Medical Director, IN Eternity Clinic · Updated 17 October 2026

Key facts

Hypertrophic scar: raised but within the wound borders; often improves over 12–24 months, faster with treatment.
Keloid: extends beyond the wound, rarely regresses and is more likely to recur after treatment.
First-line: corticosteroid injections into the scar every 4–6 weeks, with silicone gel or sheets.
Laser: an add-on for redness and texture once a scar is flatter; used cautiously in Asian skin.
Excision: never on its own for keloids; combined with an adjuvant such as injections, pressure or radiotherapy, with referral where needed.
Where: IN Eternity Clinic, 9 Scotts Road, #12-01 Pacific Plaza, Singapore.

The difference

Keloid vs hypertrophic scar: what is the difference?

Both are raised scars made of too much collagen, and both can be red, firm, itchy or tender. The difference is behaviour. A hypertrophic scar stays within the borders of the original wound, usually appears within weeks, and often flattens and pales by itself over one to two years. A keloid grows beyond the original wound into normal skin, can keep enlarging for years, rarely settles on its own, and is more likely to return after treatment.

The distinction is made in person, sometimes over several visits.
Feature	Hypertrophic scar	Keloid
Borders	Stays within the original wound	Spreads beyond it, often with claw-like edges
Onset	Weeks after the injury	Weeks to months, sometimes after a minor injury or a pimple
Course	Often softens and flattens over 12–24 months	Rarely regresses; may keep growing
Common sites	Anywhere under tension, across joints, after burns	Earlobes, chest, shoulders, upper back, jawline
Response to treatment	Usually good	Often partial; recurrence is common

The two can overlap, and some scars behave in between. Telling them apart matters because it changes how aggressively the scar is treated, whether surgery is ever sensible, and how much maintenance to expect. The broader picture, including flat and indented scars, is in scar removal in Singapore.

Causes

Why do keloids form, and who is at risk?

Keloids and hypertrophic scars are now understood as a prolonged inflammatory response in the deeper dermis. Instead of switching off once a wound has closed, fibroblasts keep laying down collagen, signalled by growth factors and kept active by tension on the skin. The scar becomes thick, with collagen in dense swirls rather than the orderly pattern of normal skin.

Skin type and family history. Keloids are more common in people with darker skin, including many Asian skin types, and run in families.
Site and tension. The breastbone, shoulders, upper back and jaw are under constant stretch from breathing and movement; keloids are rare on the eyelids, where tension is low.
The type of injury. Ear and cartilage piercings, acne on the chest and back, chickenpox, vaccinations on the upper arm, burns and surgical wounds under tension.
Age and hormones. Most keloids start between the teens and thirties, and some enlarge during pregnancy.
Healing problems. Infection, delayed healing or a wound closed under tension raises the risk of a hypertrophic scar.

In Singapore, earlobe keloids after piercing and chest or shoulder keloids after acne are the most common reasons people ask about removal. If acne is still active on the chest or back, settling it is part of preventing new keloids; see back acne treatment.

Injections

Steroid injections for keloids: how they work and what to expect

Injecting a corticosteroid directly into the scar is the usual first treatment for keloids and for hypertrophic scars that are not settling. The steroid, commonly triamcinolone (a prescription medicine), dampens the inflammation that drives collagen production and helps break down the excess. Over a series, a raised scar usually becomes flatter, softer and less itchy or painful.

Injections are given into the body of the scar with a fine needle, every four to six weeks, and the dose is adjusted at each visit to how the scar is responding. Firm keloids can be uncomfortable to inject; numbing cream and a slow technique help. Several sessions are usually needed, and a large keloid may need many.

The main side effects are local: thinning of the skin around the scar, a lighter patch, small visible vessels or a slight dip if steroid reaches the fat beneath. These are why the dose is kept to what the scar needs and why spacing matters. In some cases an anti-scarring medicine (5-fluorouracil) is combined with the steroid for scars that respond poorly. These choices are made by Dr Sin Yong at assessment.

Silicone

Do silicone gel and silicone sheets work for raised scars?

Silicone is the most widely recommended first step for preventing raised scars and for treating early hypertrophic scars. It is thought to work by hydrating the outer layer and reducing the signals that keep fibroblasts busy. It is simple and low-risk, but it is slow and depends entirely on consistent use.

How long each day. Most guidance suggests wearing sheets or keeping gel on the scar for at least 12 hours a day, ideally longer.
How long overall. At least two to three months, often longer, starting once the wound has closed.
Gel or sheet. Sheets suit flat areas and add a little pressure; gels suit the face, joints and hair-bearing skin. In Singapore heat, gels are often easier to tolerate.
Where it fits. Prevention after surgery, early hypertrophic scars, and maintenance between or after injections. On a well-established keloid, silicone alone rarely flattens it.

Laser

Laser treatment for keloids and hypertrophic scars

Lasers are an add-on for raised scars, not a first treatment. Vascular lasers such as pulsed-dye laser target the small vessels that keep a young scar red and active; long-pulsed 1064 nm Nd:YAG is another wavelength used for this. Fractional lasers make microscopic channels that can soften texture in mature, flattened scars and help steroid spread more evenly.

In Asian skin, lasers on scars carry a risk of post-inflammatory hyperpigmentation, and heat on an active keloid can sometimes provoke it. At IN Eternity Clinic, laser is used selectively, mainly once a scar has been flattened with injections, to improve redness or texture. A scar that is still growing is treated with injections first.

Removal

Keloid removal in Singapore: can a keloid be cut out?

It can, but cutting it out on its own is one of the commonest reasons a keloid comes back. The new wound is itself an injury in keloid-prone skin, and reviews report recurrence after excision alone in roughly half or more of cases, sometimes larger than before. That is why excision is planned as one step in a combination, never as the whole treatment.

When surgery is sensible, for example for a large earlobe keloid or one that has not responded to injections, it is combined with an adjuvant to stop regrowth: steroid injections into the wound edges over the following months, pressure earrings for earlobes, silicone, and in selected cases low-dose radiotherapy given within days of surgery. Radiotherapy and complex excisions are carried out by hospital plastic surgery, dermatology or radiation oncology teams. If that is the right route for you, Dr Sin Yong will say so and arrange a referral.

Cryotherapy, freezing the keloid from outside or within, is used at some centres for small keloids. It can leave a pale patch, which is more noticeable in darker skin, so it is discussed carefully.

Plan

How many sessions does keloid treatment take?

Raised scars respond slowly and in stages. The table gives typical roles; the actual plan depends on the scar, its age, the site and your history of keloids.

Typical only. Courses are set and adjusted at review.
Option	Role	Typical course	Main trade-offs
Steroid injection	First-line for keloids and stubborn hypertrophic scars	Every 4–6 weeks over several sessions	Skin thinning or lightening if overused; discomfort
Silicone gel or sheet	Prevention, early scars, maintenance	Daily for at least 2–3 months	Slow; depends on daily use
Laser	Redness and texture once flattened	A short course, spaced weeks apart	Pigment risk in darker skin
Excision with adjuvant	Large or resistant keloids	Surgery, then months of follow-up	High recurrence without adjuvant; referral
Pressure	Earlobes after excision	Worn daily for months	Comfort, compliance

Success is measured as a scar that is flatter, softer, paler and no longer itchy or painful, not as the scar disappearing. Keloids can recur months or years later, so follow-up is part of the plan.

Prevention

Preventing keloids after surgery, piercing or acne

If you have had a keloid before, tell any doctor before surgery, and avoid elective piercings, especially of the ear cartilage, and tattoos at keloid-prone sites.
After surgery, keep tension off the wound where possible, start silicone once it has closed, and seek review early if the scar thickens or itches in the first weeks.
Treat chest and back acne early, and avoid squeezing spots on the chest and shoulders.
Early review matters. A raised scar treated in its first months usually needs less treatment than one that has grown for years.

Red flags

When does a raised scar need a different kind of check?

Most raised scars are what they appear to be. A lump that appeared without any injury, grows quickly, bleeds, ulcerates or looks different from your other scars should be examined properly, and sometimes sampled, before it is treated as a keloid, because a few skin growths can mimic one. Scars that restrict movement across a joint, or burn scars over a large area, belong with a burns or plastic surgery team. Flat, red or brown marks after acne are not raised scars at all; see acne scar treatment.

Questions

Frequently asked questions

Can keloids be removed permanently?

Keloids can usually be flattened and softened, but no treatment removes the tendency to form them. Excision on its own often leads to recurrence, so it is combined with injections, pressure, silicone or radiotherapy. Follow-up continues because keloids can return months or years later.

How many steroid injections does a keloid need?

It varies with size and age. Small, young keloids may flatten after a few sessions; large or long-standing ones may need many, spaced four to six weeks apart. The dose and number are adjusted at each review to limit thinning of the surrounding skin.

Do hypertrophic scars go away on their own?

Many soften, flatten and pale over 12 to 24 months, especially with silicone and time. Treatment is considered when a scar is itchy, painful, still thickening after several months or in a visible area. Keloids, by contrast, rarely settle on their own.

Is keloid treatment painful?

Injecting a firm keloid is uncomfortable for a few seconds per point. Numbing cream, fine needles and a slow technique reduce this. Silicone is not painful. Laser feels like brief heat or snapping. Any discomfort is discussed before treatment.

Can I get my ears pierced again after an earlobe keloid?

It is generally advised not to, because the same skin is likely to form another keloid. If you choose to, discuss it with a doctor first; some people use pressure earrings and early steroid at the first sign of thickening, but the risk remains.

Does silicone gel work on old keloids?

On its own, rarely. Silicone is most useful for prevention and for early hypertrophic scars. On an established keloid it is mainly used alongside injections, or afterwards to help keep the scar flat.

Does MediSave cover keloid treatment?

Coverage depends on whether a treatment is considered medically necessary and on the scheme and insurer. Aesthetic treatments are generally not claimable. The clinic can explain what applies to you; see MediSave and insurance claims.

References

Ogawa R. Keloid and hypertrophic scars are the result of chronic inflammation in the reticular dermis. Int J Mol Sci 2017;18(3):606. doi:10.3390/ijms18030606
Berman B, Maderal A, Raphael B. Keloids and hypertrophic scars: pathophysiology, classification, and treatment. Dermatol Surg 2017;43 Suppl 1:S3-S18. doi:10.1097/DSS.0000000000000819
Mustoe TA, Cooter RD, Gold MH, et al. International clinical recommendations on scar management. Plast Reconstr Surg 2002;110(2):560-571. doi:10.1097/00006534-200208000-00031
Ogawa R, Akita S, Akaishi S, et al. Diagnosis and treatment of keloids and hypertrophic scars — Japan Scar Workshop Consensus Document 2018. Burns Trauma 2019;7:39. doi:10.1186/s41038-019-0175-y
Davis EC, Callender VD. Postinflammatory hyperpigmentation: a review of the epidemiology, clinical features, and treatment options in skin of color. J Clin Aesthet Dermatol 2010;3(7):20-31. PMID 20725554
Singapore Medical Council. Guidelines on Aesthetic Practices for Doctors (2016 edition). healthprofessionals.gov.sg/smc

These sources describe mechanisms and general evidence. They are not a promise of any individual result; suitability is decided at an in-person assessment.