Treatment

What are keloids and hypertrophic scars?

When skin heals, it produces collagen to close the wound. Sometimes it produces too much. A hypertrophic scar is a raised scar that stays within the boundary of the original wound and may flatten slowly over time. A keloid is a scar that grows beyond the original wound edge, can keep enlarging for months or years, and often feels itchy, tight or tender.

Keloids are more common in people with darker skin tones, including many people of East Asian, South Asian and African heritage, and can run in families. Typical sites include the earlobes after piercing, the chest, shoulders, upper back and jawline. Acne, vaccinations, surgery and even minor scratches can trigger them in susceptible people.

How do steroid scar injections work?

A corticosteroid such as triamcinolone acetonide is injected directly into the scar tissue. It reduces inflammation and slows the overactive production of collagen. Over a series of treatments, many scars become flatter, softer, paler and less itchy. The approach is long established in dermatology and is often a first-line option for raised scars.

The medicine is placed inside the scar rather than under it. Accurate placement matters, because steroid that spreads into surrounding normal skin can cause thinning or lightening there.

Why are injections spaced 4 to 6 weeks apart?

Re:berry doctors usually schedule scar injections at intervals of around 4 to 6 weeks. This gives the medication time to act and lets the doctor see how the scar responds before deciding the next dose. Repeating too often can increase the risk of side effects, while waiting much longer may slow progress. The interval and concentration are adjusted visit by visit.

For international patients, this rhythm means planning matters. Someone visiting Seoul for one week can usually receive one injection, then continue follow-ups with a local doctor at home or on a later trip. Our answer page How many keloid injections are needed? explains typical courses.

Who is a good candidate?

People with raised, firm keloids on the ears, chest, shoulders or jaw
Hypertrophic scars after surgery, burns or injury
Scars that itch, pull or feel painful
Raised acne scars on the chest, back or jawline

Flat, depressed or "ice-pick" acne scars need a different approach. For those, see our acne scars page, where options such as skin boosters and lasers are described.

Who should take extra care?

Tell the doctor if you are pregnant or breastfeeding, have diabetes, take long-term steroids, have an active infection at the site or have previously reacted to steroid injections. Very large keloids, or keloids in unusual places, may need a combined plan or referral, and any scar that changes rapidly or bleeds should be examined to rule out other conditions.

What happens during treatment?

Assessment: The doctor examines the scar's size, firmness, color and history, and may photograph it to track progress.
Preparation: The skin is cleaned. Ice or numbing measures may be used, as firm keloids can feel sore to inject.
Injection: Small amounts are placed into the scar at several points using a fine needle.
Plan: You will be given a suggested date for the next session and simple aftercare advice.

What results can I expect?

Many patients notice that itching and tenderness ease after the first one or two injections. Flattening tends to be gradual over several sessions. Some scars respond well, while others are more stubborn. Keloids can recur even after a good response, so ongoing monitoring is often recommended. Results vary by individual.

Side effects

Temporary pain at the injection site is the most common effect. Other possible side effects include:

Skin thinning or a slight dip around the scar (atrophy)
Lighter skin patches (hypopigmentation), more visible on darker skin
Small visible blood vessels (telangiectasia)
Rarely, menstrual changes or effects on blood sugar with larger doses

Most of these are dose-related, which is one reason the doctor adjusts concentration and spacing carefully.

Can scar injections be combined with other treatments?

For stubborn or larger scars, doctors sometimes combine steroid injections with other methods such as silicone gel or sheets, pressure therapy, laser treatment to reduce redness, or other approaches discussed at consultation. Re:berry's philosophy of designing a combination rather than relying on one method applies here too, but the plan always follows the diagnosis.

How is progress tracked between visits?

Photos taken at each visit, along with notes on height, firmness and symptoms, help the doctor compare sessions objectively. Between appointments, keep the area moisturized and protected from sun, and note any change in itch or size so you can report it at the next visit.

Preventing new keloids

If you know you form keloids, it helps to avoid elective piercings and tattoos, treat acne early, and tell any doctor before surgery. Silicone products and early follow-up after a wound can reduce the chance of a new keloid forming.

How is pricing decided?

Pricing depends on scar size, the number of scars and the number of sessions planned. It is confirmed at consultation. Use the channels on our Booking page to request an appointment.

Do keloid injections hurt?

Keloid tissue is dense, so injections can feel sharp and pressured, especially on the first visit. Ice, numbing cream or slow injection technique may help. Many patients find later sessions more comfortable as the scar softens. Let your care team know if you are anxious so they can plan comfort measures.

Can a keloid come back after injections?

Yes, keloids can recur, even after a good response. The tendency to form keloids is partly genetic and does not disappear with treatment. Continuing silicone use, avoiding new trauma to the area and booking a check if the scar starts to thicken again can help catch recurrence early.

Can I treat an ear keloid from a piercing?

Earlobe keloids from piercings are among the most common and often respond to steroid injections. Larger earlobe keloids are sometimes removed surgically and then injected afterward to lower the chance of recurrence, which may require referral. The doctor will examine the keloid and explain which approach fits its size.

Can I continue scar injections at home after visiting Seoul?

Many international patients do. Ask for a written summary of the medication, concentration and dates used, and share it with a dermatologist at home. This helps them continue the course safely and adjust the next dose based on how the scar has responded since your Hongdae visit.