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15 Green Lane East, Remuera,  Auckland, New Zealand
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Monday - Friday: 7:45 am - 5:00 pm

The Science Behind It

Keloid scars occur due to an overactive wound healing response, where the body produces too much collagen, leading to the formation of a raised, fibrous scar that extends beyond the original injury. This abnormal healing process involves the proliferation of fibroblasts and excess deposition of extracellular matrix components, including collagen. Genetic predisposition plays a role in keloid formation, making it more common in individuals with a family history of keloids or certain ethnic groups, particularly those with darker skin. The exact molecular mechanisms behind keloid formation are still being studied.

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Keloid Scar Treatment Options at Scars & Lasers

Treatment Modality

What It Does

Best For

Key Benefits

Notes & Limitations

Intralesional Steroids (e.g. Triamcinolone)
Reduces inflammation and suppresses excess collagen production
Active, raised, itchy or painful keloids
Flattens scar, reduces redness, itch and discomfort
May require multiple sessions; risk of skin thinning or pigment change if overused
Anti-metabolites (e.g. 5-Fluorouracil)
Inhibits abnormal fibroblast activity and collagen overproduction
Steroid-resistant or recurrent keloids
Improves flattening and reduces recurrence when combined with steroids
Typically used in combination therapy rather than alone
Vascular Lasers (e.g. pulsed dye / vascular platforms)
Targets abnormal blood vessels feeding the keloid
Red, inflamed, symptomatic keloids
Reduces redness, pain and itch; helps calm active scars
Alma Hybrid™ Laser
Combines ablative and non-ablative fractional laser energy
Thick, established or recurrent keloids
Improves texture, thickness and flexibility of scar
Used as part of staged treatment plans rather than a single session
UltraClear™ Cold Ablative Laser
Creates precise micro-channels with minimal thermal damage
Resistant or bulky keloids requiring enhanced penetration
Allows targeted scar remodelling with faster recovery
Often paired with Laser-Assisted Drug Delivery for optimal results
Laser-Assisted Drug Delivery (LADD)
Uses fractional laser channels to deliver medication deeper into scar tissue
Keloids requiring improved response to steroids or anti-metabolites
Enhances treatment effectiveness while reducing injection discomfort
Medications used depend on scar type and patient factors

Nd:YAG Laser

(Available on Excel V and Excel V Plus)

Best for

Mild cases or isolated vessels.

How It Works

The long-pulse Nd:YAG laser emits energy at a wavelength absorbed by haemoglobin in blood vessels. This heat causes the targeted vessels to collapse, effectively treating both surface red veins and deeper blue veins.

Results

Treated vessels may disappear immediately or gradually fade over several weeks.

Rejuran (Polynucleotides)

(Candela VBeam Perfecta, Excel V, Excel V Plus, Sciton BBL)

Best for

Stimulating collagen and vascular remodelling to reduce persistent skin redness.

How It Works

Often recommended in combination with vascular laser or BBL treatments to enhance skin healing, texture, and redness reduction.

Combined Vascular Laser and BBL Approach

(Candela VBeam Perfecta, Excel V, Excel V Plus, Sciton BBL)

Best for

More severe cases or large areas of visible facial veins and redness, particularly in rosacea.

How It Works

This approach layers multiple vascular-targeting technologies in one session, including:

  • Nd:YAG Laser: For deeper blue or purple visible blood vessels.
  • Vascular-Tailored Settings of Broad-Based Light (BBL): For diffuse redness and widespread visible capillaries.
  • Pulse Dye Laser: (Candela VBeam Perfecta, Excel V Plus) For bright pink surface vessels and fine skin flushing.

Results

Effectively reduces visible veins, diffuse redness, and facial flushing commonly seen in rosacea.

Keloid scars are caused by an exaggerated healing response and often require combination therapy. At Scars & Lasers, treatment is tailored to scar activity, thickness, symptoms (pain/itch), colour, and response to prior therapies.

Why Combination Therapy Matters

Keloid scars rarely respond to a single treatment alone. Combining injections, vascular lasers, fractional lasers and drug delivery techniques allows us to:

  • Calm inflammation
  • Reduce abnormal collagen production
  • Improve scar thickness, colour and symptoms
  • Lower recurrence risk

Important Considerations

  • Keloids cannot always be permanently removed, but they can usually be significantly improved and controlled
  • Multiple treatments are often required
  • Maintenance therapy may be needed for long-term control
  • Treatment plans are individualised after clinical assessment

Consultation & Assessment

All keloid scars are assessed by our experienced laser dermatology team to determine:

  • Scar activity and thickness
  • Previous treatments and response
  • Skin type and pigment risk
  • Suitability for laser-based therapies

FAQs

Frequently Asked Questions

What is a keloid scar?

A keloid scar is an overgrowth of scar tissue caused by excessive collagen production during healing. Unlike normal scars, keloids extend beyond the original injury and may continue to grow over time.

What causes keloid scars to form?

Keloids develop due to an exaggerated wound-healing response. They are more common after surgery, trauma, burns, piercings, acne or insect bites, and may have a genetic or skin-type predisposition.

Can keloid scars be permanently removed?

Keloids cannot always be permanently removed, but they can usually be flattened, softened, and symptoms significantly reduced. Long-term control often requires combination therapy and ongoing monitoring.

What symptoms do keloid scars cause?

Keloids may cause:

  • Itching or tenderness
  • Pain or burning sensations
  • Redness or colour change
  • Tightness or reduced skin flexibility

Symptom control is a key treatment goal.

What treatments are available at Scars & Lasers for keloids?

We offer a multimodal approach, which may include:

  • Intralesional steroid injections
  • Anti-metabolites (such as 5-Fluorouracil)
  • Vascular laser therapy
  • Fractional laser treatment using Alma Hybrid™
  • Cold ablative fractional laser with UltraClear™
  • Laser-Assisted Drug Delivery (LADD)

Treatment selection depends on scar size, activity, thickness, symptoms and previous treatments.

How do steroid injections help keloid scars?

Steroids reduce inflammation and suppress abnormal collagen production within the scar. This helps flatten the keloid and reduce pain, itch and redness. Multiple treatments are often required.

When are anti-metabolites used for keloid scars?

Anti-metabolites such as 5-Fluorouracil are commonly used in combination with steroids, particularly for resistant or recurrent keloids. They help reduce fibroblast activity and lower recurrence risk.

What role do vascular lasers play in keloid treatment?

Vascular lasers target the abnormal blood supply that fuels active keloids. This helps reduce redness, inflammation, itch and pain, and improves response to other treatments.

How do Alma Hybrid™ and UltraClear™ lasers help keloid scars?

These fractional lasers create controlled micro-injury within the scar to:

  • Improve thickness and texture
  • Increase flexibility
  • Enhance penetration of medications
    They are typically used as part of a staged treatment plan, not as standalone therapy.

What is Laser-Assisted Drug Delivery (LADD)?

LADD uses fractional laser channels to deliver medications deeper into keloid tissue. This improves treatment effectiveness while reducing the need for higher injection doses.

Is keloid scar treatment covered by ACC?

In some cases, keloid scar treatment may be covered by Accident Compensation Corporation if:

  • The scar resulted from an accepted injury (e.g. burn, trauma, surgery)
  • The treatment is deemed necessary for function or symptom control

ACC funding decisions are individual and not guaranteed. Some components of treatment may require private payment.

How many treatments are usually required?

Most keloids require multiple treatment sessions over time. The exact number depends on scar severity, response to therapy, and whether maintenance treatment is required to reduce recurrence.

Important ACC & Treatment Disclaimer

ACC funding eligibility is determined by the Accident Compensation Corporation on a case-by-case basis. Approval is dependent on injury acceptance, clinical indication, and ACC policy at the time of application. Not all treatments offered at Scars & Lasers are ACC-funded. Private fees may apply for unfunded components of care.

Learn more about ACC Incidents