Keloids can be removed or reduced by dermatologists, plastic surgeons, and specialized scar treatment centers. The right provider depends on the size and location of your keloid, whether you’ve had previous treatment, and what combination of therapies you’ll need to keep it from coming back. Costs range from a few hundred dollars up to $3,500, and insurance coverage depends on whether the keloid causes a functional problem.
Which Doctors Remove Keloids
Your first stop is typically a board-certified dermatologist. Dermatologists diagnose keloids, distinguish them from other types of raised scars, and perform most nonsurgical treatments like steroid injections and cryotherapy. Many dermatologists also perform minor surgical excisions for smaller keloids, particularly on the earlobes.
For larger or more complex keloids, especially those on the chest, back, or face, a reconstructive plastic surgeon is often the better choice. Plastic surgeons use advanced techniques to remove the keloid and close the wound in ways that minimize tension on the skin, which helps reduce the chance of regrowth. If your keloid is near the ear, nose, or throat, an otolaryngologist (ENT specialist) may handle the removal.
The key is finding a provider who treats keloids regularly, not just occasionally. Keloids behave differently from normal scars, and a doctor experienced with them will plan for recurrence prevention from the start rather than simply cutting the keloid out.
Where to Find Specialized Treatment
Academic medical centers and university-affiliated hospitals often have dedicated scar clinics where dermatologists and plastic surgeons work together. These centers typically offer the full range of keloid treatments, including surgical excision, laser therapy, steroid injections, cryotherapy, and post-surgical radiation. If you’re near a major city, searching for “keloid clinic” or “scar treatment center” at a nearby academic hospital is a good starting point.
For people without access to a major medical center, a local dermatologist can handle steroid injections and refer you to a surgeon if needed. Some dermatology practices now offer superficial radiation therapy on-site, which is one of the most effective ways to prevent keloids from returning after surgery. If your dermatologist doesn’t offer radiation, they can coordinate with a radiation oncology center nearby.
Treatment Options and What to Expect
Keloid treatment isn’t one-size-fits-all. The approach depends on the keloid’s size, location, how long you’ve had it, and whether it’s causing symptoms like pain or restricted movement.
Steroid Injections
For smaller or newer keloids, steroid injections are often the first treatment. A corticosteroid is injected directly into the keloid to soften and flatten it over time. Sessions are typically spaced about four weeks apart, though some providers schedule them every two to three weeks. Most people need multiple rounds before seeing significant improvement. Injections won’t fully remove a keloid, but they can reduce its size, firmness, and discomfort considerably.
Surgical Excision
Surgery physically removes the keloid. It’s the most direct option, but it comes with a serious catch: when used alone, keloids grow back 50 to 80 percent of the time. Some studies report recurrence rates as high as 100 percent with surgery alone. This is why reputable providers almost never recommend surgery without a follow-up treatment to prevent regrowth.
Surgery Plus Radiation
Combining surgical removal with radiation therapy afterward is the most effective approach available. When radiation is delivered within the first week after surgery at an adequate dose, recurrence rates drop below 10 percent. This is a dramatic improvement over surgery alone. The radiation is superficial, meaning it targets the skin surface and doesn’t penetrate deep into the body. Sessions are short and typically completed within days of the procedure.
Cryotherapy
Traditional cryotherapy freezes the keloid from the outside with liquid nitrogen, but it can cause skin lightening and blistering. A newer technique called intralesional cryotherapy inserts a small needle into the keloid and freezes it from the inside out. This destroys the dense scar tissue at the core while leaving the surface skin and its pigment-producing cells mostly intact, which makes it a better option for people with darker skin tones who are concerned about discoloration.
Laser Therapy
Laser treatments can reduce redness and flatten keloids, and they’re sometimes used alongside steroid injections. Lasers work best on keloids that are relatively flat but discolored, or as a finishing treatment after other therapies have reduced the bulk.
Make Sure It’s Actually a Keloid
Before pursuing removal, confirm that what you have is a keloid and not a hypertrophic scar. The two look similar (both are raised and thickened) but behave very differently. A keloid grows beyond the borders of the original wound and does not improve on its own. A hypertrophic scar stays within the boundaries of the injury and often starts to flatten after about six months.
Location and skin tone also offer clues. Keloids most commonly appear on the earlobes, chest, upper back, and face, and they’re more common in people with darker skin. Hypertrophic scars show up on all skin types and tend to form over joints and areas of skin tension. If your raised scar has been slowly shrinking, it’s likely hypertrophic, and the treatment plan would be less aggressive.
Why Recurrence Prevention Matters
The single most important thing to understand about keloid removal is that cutting out a keloid creates a new wound, and that new wound can trigger an even larger keloid. This is why any provider who recommends surgery should also have a clear plan for what happens next.
Beyond radiation, other post-surgical strategies include continued steroid injections into the surgical site and pressure therapy. Pressure garments or devices are worn over the treated area for a minimum of 12 months, and ideally 18 to 24 months. To be effective, pressure needs to be applied consistently and started within two months of the procedure. For ear keloids, custom pressure earrings serve the same purpose.
Cost and Insurance Coverage
Keloid removal costs anywhere from a few hundred dollars for steroid injections to around $3,500 for surgical excision, depending on the keloid’s size, location, and the complexity of the procedure. If you need post-surgical radiation, that adds to the total.
Insurance coverage hinges on whether the keloid causes a functional problem. Insurers, including Medicaid, generally cover removal when the keloid causes issues like restricted movement, pain, obstruction of an opening (such as the ear canal), difficulty breathing, problems with vision, or distortion of nearby body parts. If the keloid is painful, infected, draining, or growing rapidly, and conservative treatments like steroid injections haven’t worked, that also strengthens a medical necessity case.
What insurance typically will not cover is removal done purely to improve appearance. Social and emotional distress from a keloid, while very real, usually doesn’t meet the medical necessity threshold insurers use. If your keloid is purely cosmetic, expect to pay out of pocket. Ask your provider’s billing office to submit a prior authorization with documentation of any functional symptoms before scheduling the procedure, so you know where you stand financially.