A Special Note About Keloid Scars

Before starting any scar treatment, it's important to know what type of scar you have.

Most Caesarean scars heal as flat, mature scars or occasionally become hypertrophic scars, which are raised but remain within the boundaries of the original incision. These scars often respond well to treatments such as silicone therapy, scar massage, microneedling, cosmetic acupuncture and LED red light therapy.

Keloid scars are different. A keloid grows beyond the edges of the original incision and results from an overactive healing response, where the body continues producing excess collagen long after the wound has healed.

Because treatments like microneedling work by creating controlled micro-injuries that stimulate new collagen production, they are generally not recommended for untreated keloid scars. In some people, this could potentially trigger additional collagen formation and worsen the appearance of the keloid.

Similarly, there is very little research on cosmetic acupuncture for keloid scars, and because it also involves needle insertion, many practitioners avoid treating directly through an active keloid unless it is part of a treatment plan guided by a dermatologist or plastic surgeon.

LED red light therapy is different. It doesn't create a wound or physically injure the skin. Current evidence suggests photobiomodulation may help regulate inflammation and support normal wound healing, but there is insufficient evidence to recommend it as a treatment for established keloids, and it should not be expected to reduce or remove them.

If your scar is raised, itchy, painful, continues to enlarge, or extends beyond the original incision, it's worth having it assessed before beginning any collagen-stimulating treatment. Evidence-based first-line treatments for keloids typically include silicone gel or silicone sheets, pressure therapy in selected cases, and corticosteroid injections, with other options such as laser therapy, cryotherapy or surgical revision reserved for selected patients under specialist care.

The key message is simple: not all scars should be treated the same way. Identifying whether your scar is a normal mature scar, a hypertrophic scar or a keloid helps ensure you choose the safest and most effective treatment.