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My Keloid Treatment Journey Using Kenalog

My Keloid Treatment Journey Using Kenalog
Reading Time: 18 minutes

Disclaimer: I started my keloid treatment journey on 4/13/2020 and will continue to update this post. Please come back for regular updates. Feel free to join my newsletter (sign-up form is below) as I will make updates via e-mail about my keloid treatment progress!

I started documenting my keloid treatment journey on my Instagram stories. Click below to see my progress!

If you’ve been following along, head over to the ToCs for updates.

How Did I Get My Keloid?

I’ve had my most prominent keloid scar since I was 9 years old. It happened when my mom picked the chicken pox scar off my chest. It started as a small dime-sized scar. Over the years, it grew into a 3″ wide scar resembling a chicken bone. I kept my scar hidden pretty well. I wore high-neck shirts and halter tops.

No one really knew about it until I decided to wear whatever TF I wanted, starting in 2011. Exposing my scar was a scary, vulnerable, and at the same time very empowering experience. I was tired of hiding my imperfections and wanted to wear whatever I wanted.

I let people assume what they wanted when they saw my scar.

Having a scar does not define my character and is such a minor part of who I am as a human being.

Have a read below if you want to see how I learned to love my scar!

Related: My Keloid Story: How I Learned to Love My Keloid Scar

What is a Keloid?

Keloids are healed wounds that do not know they’re healed. They are raised because they are inflamed due to the body’s healing process going into overdrive to treat the wound. Keloids typically occur on the chest, shoulders, back, face, or ears.

Keloids are not just unsightly, they often itch and sting. They can also cause some emotional pain depending on how a scar was formed or how someone or others perceives scars.

Keloids can form from a wound, pimple, or just randomly. They’re also very common in people of Asian or African descent.

raised keloid scar on chest schimiggy

Raised keloid scar on my chest.

What Are the Available Keloid Treatments?

Treating keloids is very tricky.

You can excise (cut out) the keloid, but they often grow back and larger than before.

You can get steroid injections, but they often hurt and require years of treatment (if not indefinite treatments) to maintain a flat scar.

You can opt for cryotherapy, which freezes the scar and sheds a layer of it through a scab. This process can take years and is often painful and can become infected if not cared for appropriately.

Some treatments combine ointments, creams, radiation therapy, silicone sheets, etc. to their keloid treatment to keep it flat.

The treatment process can be very expensive and take years to achieve the results you want.

Some Background Info On My Scar

Back in 2008, I started my keloid treatment journey with 5-FU (steroid) injections. My dermatologist was based in San Diego and I lived in Orange County, California. I couldn’t keep up with the injections because it would take 2 hours to get to the hospital and my insurance did not cover the procedures, so paying out of pocket was very expensive.  I kept it up for 8 months and saw improvements in my scar, but they came back as soon as I stopped.

I moved to Seattle in 2013 and placed my keloid treatments on the back burner. I had bigger fish to fry. I also learned how to love my scar.

Fast forward to 2020, I decided to reinitiate my keloid treatments. I have a great insurance plan (Premera) and they cover the first $2,000 deductible on a negotiated rate for Kenalog injections.

I made this decision because I could finally afford it (with insurance) and I was curious to see how my 16 year old scars would react to steroid treatment. While I am committed to doing this for science, I would also love to know what it’s like to feel “normal.”

My Keloid Treatment Journey

Let’s get into what you’re here for! You want to know if steroid injections worked. Read my experience below to find out.

If you’ve been following along, here is a quick Table of Contents of my journey. Click on the injection session you want an update on.

1st Injection – April 13th, 2020

I visited the Modern Dermatology clinic (in Seattle, Wash.) during the coronavirus pandemic. They were observing social distancing rules and were very adamant about not admitting any patients diagnosed with COVID-19. They also had adequate signage reiterating social distancing rules within the waiting room.

I filled out my paperwork and within 3 minutes, a nurse invited me into the patient room and asked the number of keloid scars I was looking to treat. I told her 6; one on my chest (presternum), 3 on my right shoulder, and 2 on the nape of my neck.

Dr. Carly J. Roman came in a few minutes after my consult and asked how the scars had formed and if I had had them treated before. She then went straight into injections. I received injections of Kenalog 10mg/cc (also referred to as Kenacort) into each of my scars.

Dr. Roman advised me to massage my largest scar (the one on my chest) to evenly distribute the steroid. She mentioned that it may take around 3 treatments for my smaller shoulder and neck scars to flatten. My chest scar would have to be ongoing because it is larger and may react much slower than the other scars.

The injections took no more than 4 minutes and I was on my way. She advised me to come back in 6-8 weeks for my second session. I was in and out of the clinic within 25 minutes.

I did not use any numbing cream and the injections were not painful as I had imagined. I do have a high pain tolerance. My injection areas were patched up with bandaids that I was required to wear for the day. My daily routine could go on as normal (ie. working out, showering, etc.).

After my first appointment, I removed my bandages and could see my scars looked puffier than normal (from the Kenalog injections), were a bit blanched (turned white) and felt taut. After a few days, the scars flattened to how they were when I first entered the clinic.

No immediate results yet, and that is normal. This process takes time.

1st injection 3 inch chest keloid 4-13-2020

1st Injection in chest keloid

1st injection keloids scars on nape of neck from surface piercing 4-13-2020

1st injection in neck keloids

1st injection shoulder keloid scars 4-13-2020

1st injection in shoulder keloids (side)

1st injection shoulder keloid scars back 4-13-2020

1st injection in shoulder keloids (back)

2 Weeks After the 1st Injection – April 27, 2020

Two weeks after the initial injection, I noticed some softening of the scars and the smallest one on the back of my right shoulder flattened entirely. I also noticed there were less itching and irritation of my scars overall.

My neck scars had softened and were noticeably flatter than before.

I am looking forward to my second session!

2nd Injection (5 weeks later) – May 19, 2020

I was slated to come in every 6-8 weeks and did not want time to lapse in between treatments, which might cause my scar to grow back. By May 10th, my scar had already started to feel uncomfortable again. I felt a stinging pain and this is typically indicative of the keloid scar reforming.

On my second appointment, I asked Dr. Roman for a stronger dose of Kenalog. I read online that most people go in a few times a month for Kenalog 10 mg/cc shots and less if the dosage were higher. She advised that she would administer 20 mg dose and I would come back in within 6 weeks. She stated that a higher dose (40 mg) could cause discoloration and she did not want to take any chances.

During this treatment session, she injected the areas that were most raised and left the flat ones untreated.

Here are photos of my scar 1 day after the second injection. You can see the scars are shrinking because they are more puckered (or wrinkled).

chest keloid scar kenalog steroid treatment 2nd injection

Keloid scar on chest – 2nd Injection

keloid scar steroid treatment nape of neck 2nd injection

Nape of Neck Keloid Scar – 2nd Injection

shoulder keloid scar front side 2nd treatment of steroid injection treatment

Back Shoulder Keloid – 2nd Injection

shoulder keloid scar back side 2nd treatment of steroid injection treatment

Front of Shoulder Keloids – 2nd Injection

Between my first injection and second injections, I’ve lost 6 pounds. I’ve been eating healthy and exercising regularly (circuit training) with a friend Tim via Zoom. My goal is 130 lbs, which is only 10 more pounds to go!

I am super excited for my quarantine transformation! The “Stay Healthy” motto has been more than just trying to flatten the coronavirus curve. And I am for it! #quarantinebody #bodybyTim #TimWuWorkouts

3rd Injection – July 21, 2020

I went in for my third injection and mentioned to Dr. Roman that my scars are feeling like they’re growing back in between my 8 week sessions. She recommended I come in every 6 weeks so that we didn’t keep working backwards.

She gave my keloids a good amount of injections this time around. In the last session, she missed the front shoulder keloid and it definitely grew back and hardened.

My chest keloid has flattened a lot compared to previous sessions. Some parts of the scar also appear less puckered and puffy. The color has also changed. Some parts of the scar appear lighter and blend in with my skin tone. I am looking forward to my next session.

My neck keloids have subsided immensely. I can feel the scars faintly. They have also turned a lighter color. Hopefully, after this session of injections, the neck scars will be flush with the surrounding skin. The larger scars will still need work, especially my chest one.

chest keloid after third injection schimiggy

Chest keloid scar after third injection

front side of shoulder keloids third injection

Shoulder keloids (front) after third injection

back side of shoulder keloids third injection

Shoulder keloids (back) after third injection

neck keloid scars after third steroid injection

Neck keloid scars after third steroid injection

4th Injection – August 24, 2020

I went in for my 4th injections today. Dr. Roman treated all my keloids, including the ones on my neck that are already very flat. The neck scars have flattened the most but are not completely flush to my normal skin yet. I was advised to massage my scars so that the steroid is distributed evenly.

Dr. Roman also suggested that I try laser treatments (on my chest scar) between November and March, when there is less sun and colder in Seattle, Washington. The treatments would lighten the scar to be closer to my actual skin tone. The second laser treatment she suggested would blend the edges of my scar and remove any pink color that develops from the steroid treatments. I may consider it when the time comes.

For now, we are focusing on flattening the scars as much as possible. As slow as it is, I am still seeing progress and excited for what’s to come.

Here are photo updates of my scars.

keloid scar steroid treatment 4th injection chest scar

4th Steroid Injection – Chest Keloid Scar

My chest scar definitely looks lighter and flatter than before.

keloid scar steroid treatment 4th injection front shoulder

4th Injection – Front Shoulder

The shoulder scars are stubborn. I notice them becoming lighter in color but they still feel hard and fibrous when I press down on them.

keloid scar steroid treatment 4th injection back shoulder

4th Injection – Back Shoulder

keloid scar steroid treatment 4th injection nape of neck scars

4th Steroid Injection – Keloid scars on neck

I am super happy with the progress of my neck scars. Even if the color remains, I am super glad they are no longer raised.

If you’re wondering, the long mark on my neck is a birthmark.

5th Injection – September 30, 2020

I went in and stated that my scars did not change much in the last session. My shoulder scars were still very firm and raised. My chest scar had not flattened more.

Dr. Roman increased my dosage from 20mg to 40mg with 6-8 weeks in between injections. She stated that the injection dosage will feel smaller because the Kenalog is not being diluted.

I received injections on my chest and shoulder keloids and was instructed to massage the steroid into my scars afterward.

My neck scars have subsided and did not need additional treatment. I will ask her to take a look at them at the next session just to be sure no treatment is needed.

I am hoping to see some drastic changes on my shoulder scars before the next injection.

Photo Updates  – October 17, 2020

My shoulder scars have started to soften but are still raised.

My chest scar has flattened and lightened in color. The edges of the scar are still dark.

Overall, I am happy with the results and would like to keep the same dosage on my next session.

Chest Keloid Scar 5th Injection October 2020

Chest Keloid Update

Front Shoulder Keloid Scar 5th Injection October 2020

Front Shoulder Keloid Update

back shoulder Keloid Scar 5th Injection October 2020

Back Shoulder Keloid Update

Neck Keloid Scar update October 2020

Neck Keloid Scar Update – Oct 2020

6th Injection – November 12, 2020

I went in and received injections on all my scars, including the ones on my neck. They were starting to feel a little raised.

Dr. Roman continued with the 40ml dosage on my scars. She recommends that on my 8th injection, I add laser therapy to lighten the color on the edges of the scar. She also recommended my 7th injection in 4 weeks and then my 8th injection plus laser treatment in another 4 weeks.

My shoulder scars have started to soften and have lightened in color. My chest scar is gradually flattening, but still slightly raised. The chest scar has also lightened and started to blend into my natural skin color.

Over time, your scars will get used to the chemicals, so a higher dosage is required each time. The 40ml is the highest dosage, so I will need to continue with the same dosage and receive a higher number of treatments.

Overall, I am still satisfied with how my scars are flattening and hope that by next year, my treatments will be complete and I will only need to go in for maintenance injections.

7th Injection – December 7, 2020

I went in for my injection. My scars have not changed much.

I did not take any photos from this session.

8th Injection – February 15, 2021

My chest scar is significantly flatter now. I was supposed to get laser treatment to lighten my scar today but I recently just back from Hawaii and need to let my tan fade.

I did not take any photos from this session.

9th Injection + Laser – March 17, 2021

I had my first laser treatment today! Dr. Roman used the Cryosure YAG laser on my chest and shoulder scars and mentioned that it would take approximately 8 treatments before we see desirable results. YAG lasers are used on varicose veins, laser hair removal and apparently skin lightening!

She placed goggles to cover my eyes and the laser treatment lasted less than a minute. After the laser treatment was administered, she injected Kenalog into my scars. She stated that the laser should help the steroid penetrate deeper and be more effective in flattening and lightening my keloids.

I was patched up with bandaids and given sunscreen and an ice pack to cool my scar down in case it gets too warm. I am expected to wear my chest bandaid throughout the evening.

She then recommended that I book another laser + injection appointment 8 weeks from now. My laser treatment was also included in the regular cost of my treatments (currently $93 USD per visit).

Here is my scar today!

My scar is much flatter, doesn’t itch, color has lightened and  I feel much better about wearing low cut tops.

My shoulder scars (not shown) are much softer. They are still stubborn so it took a while.

keloid scar post 1 year of steroid treatment schimiggy

1 year after monthly steroid injections

Here is the laser Dr. Roman used.
cryosure yag laser treatment for keloid scars

10th Injection + Laser – May 12, 2021

My neck keloids have started to feel a little raised. I will request a maintenance injection and laser for better results.

I came in and got my 2nd laser and 10th steroid injection. This time she applied the laser twice across the scar and it turned really red. The red subsided after a day.

My arm scars feel much softer and my chest scar has seemed to darken from the laser. Hoping that it will peel and lighten soon.

Below is a picture of my scar on 5/18/2021. It feels very flat and soft.

ygoodm yoga vertical stripe activewear set in khaki

11th Injection + 3rd Laser – August 11, 2021

I got my chest and shoulders treated. I had not seen much change since the last appointment.

12th Injection + 4th Laser – October 11, 2021

I went in and had the scars on my chest, shoulders, and neck treated. I received laser treatment on my chest and shoulder. The injections still hurt, but the laser has gotten more tolerable.

My shoulder scars received more of the Kenalog because they were still being stubborn. 8 days after my treatment, I noticed that my shoulder scars were getting softer.

The color of the scars still seems the same. It gets better when I have gotten a tan.

chest keloid scar october 11 2021 schimiggy alex tran

Chest Keloid Scar with Kenalog steroid injection treatment – October 11, 2021

Neck Keloid Scars with Kenalog steroid injection treatment - October 11, 2021

Neck Keloid Scars with Kenalog steroid injection treatment – October 11, 2021

13th Injection + 4th Laser – December 6th, 2021

I went in for my injection and laser treatment and had no new concerns. The appointment was routine. 

My shoulder scars are still stubborn and have not softened since my last visit. I will ask my derm to try 5FU on my next visit. I have read that it tends to melt the scars and prevent the scar from growing.

14th Injection – January 31, 2022

I went in for my injection but did not receive laser treatments because the machine was being serviced. I noticed that a section of my larger shoulder scar has completely flattened. My shoulder scars have also softened significantly after being so stubborn since the start of my treatments.

I asked Dr. Roman about using 5FU and she explained that my scars are seeing so much progress that using 5FU may cause damage because it is a chemical that halts cell growth and division. Using 5FU now could cause my keloids to decay and cause potential atrophy and wounding.

Dr. Roman treated me with a 20mg dose of Kenalog and I am due for my next visit in 6 weeks and not the typical 8-10 weeks.

15th Injection + 5th Laser – March 2022

I got my injection and laser treatment with Dr. Roman. My scars have not changed much from the last appointment.

16th Injection – July 18, 2022

Dr. Roman is currently on maternity leave so I had an appointment with Dr. Collyer. He does not specialize in lasers so I only received injections during my appointment.

My scars are the same and have not flattened more. Dr. Collyer suggested that I make an appointment with Dr. Grabowski in 6 weeks because he knows how to apply laser treatment to scars.

17th Injection – August 31, 2022

Dr. Roman is still on maternity leave so I had only the injections with Dr. Grabowski this time. He injected my areas with a lot of steroid this time, leaving them puffy and sore. I did not get my laser treatment done during this session.

18th Injection + 8th Laser – October 12, 2022

Dr. Roman is back and I went in for a routine injection + laser session. Nothing was out of the ordinary. I did not see significant changes from my last treatment.

19th Injection + 9th Laser – February 9, 2023

I’ve been traveling quite a bit and was unable to make an appointment until February 9th. My scars were still the same with some itching returning on the shoulder scars. 

20th Injection + 10th Laser – April 3, 2023

I came in for a routine treatment session and did not notice anything different. My scar treatments seem to have plateaued.

21st Injection + 11th Laser – June 1, 2023

After seeing how my scars have plateaued, Dr. Roman increased my steroid injections to 20 mg/cc and the laser machine seemed hotter this time. The day after my treatment, my scar puffed up and I was concerned. This swelling persisted for 3 days and then subsided. 

June 2023 puffy keloid scar on chest from injection and laser

Puffed up keloid scar (1-day post treatment)

After the puffiness subsided, my chest scar seemed to have flattened even further. My shoulder scars are still raised but a bit softer. The laser was also so hot that it left tiny scab marks on my scars.

This will be my last laser treatment until Fall because it’s getting sunnier and warmer outside and laser treatments are not recommended.

Here are photos of my scar on June 14, 2023 (after the puffiness has gone away).

Scar treatment kenalog injection and laser June 2023 front

June 2023 Scar treatment kenalog injection and laser shoulder

June 2023 Scar treatment kenalog injection and laser neck

My neck scars are still flat, so no treatment is needed.

June 2023 Scar treatment kenalog injection and laser laser scabs shoulder

My shoulder scars have some laser scab marks. The laser machine was really hot during this treatment.

Before and After Photos

#1 My Neck Keloid Scars

These scars responded the best. They’re also much smaller compared to other scars. The scars completely flattened and lightened in color. It took 5 months (April 2020 to August 2020) to flatten. I now go in every 6 months to touch up with steroid injections.

before and after keloid scar steroid injections

Final Thoughts

I hope that my story might help others who are currently suffering from keloids. Keloids can be disfiguring and emotionally distressing. I’ve been there and decided to take care of it because I am in a financial situation to do so. If my story gives you hope, I am glad you have found this little corner of my world.

If you have any questions, feel free to contact me on Instagram @schimiggy. I love connecting with people who are interested in learning more about the keloid treatment process, have other questions, or just want to share their stories.

Glad our scars could bring us together!


FAQ:

What Kenalog dosage was used on your scars? My doctor used Kenalog 10mg/cc initially. She then increased it to 20mg and then to 40mg for my more stubborn shoulder scars.

Based on my experience, injections are the most effective but can take a while to see results depending on your body/skin and how old/where the keloids are.

It’s important to note that injections are trial and error. The amount of dosage and frequency of the shots will vary for each person so you have to discuss with your doctor.

Just like any other medication, your body can get used to the injections and it will seem like they stopped working but you should be alternating the dosage (usually starting low and then going higher).

How much do kenalog injections cost? My insurance (Premera) completely covered 100% of the cost of my treatments. I didn’t pay anything out of pocket. I did not even have to explain why I was there to treat my scars. My doctor knew and went straight into treatment without giving me other options.

Will steroid injections last forever?
Steroid injections are not a permanent fix. You will need to go in 1-2 times a year for touch ups. It’s best to keep an eye on your scar and go in as soon as you notice any itching, stinging or changes in the keloid shape and size.

Do steroid injections hurt? It really depends on the person. I have a high pain tolerance and the process is so quick that the pain typically subsides within minutes. I do not use any numbing cream during treatments.

For those who have a lower pain tolerance, you can ask for a numbing cream (lidocaine) that takes approximately 90 minutes to become effective and even then, it does not take the discomfort away 100%. There will still be a tiny amount of stinging.

What happens immediately after a steroid injection? The area will become puffy and feel taut (tight). You may need to massage the steroid into your scar to evenly distribute the chemicals. There may be slight bleeding but should clot within an hour. Over the next few weeks, the steroid will flatten the keloid and the color will look more even with your natural skin tone or a little darker.

Over time, the scar will begin to look like it’s “dissolving.” That is great news and means that the inflammation is going away and your scar will blend into your skin in no time. The scar will flatten and become flush with the surrounding skin.

Did you combine kenalog with other treatments? No. I was not advised by my dermatologist that I needed to.

Will Kenalog work for me? Injections are not a one treatment fits all situation. Some people will react differently to certain treatments and some will have success with procedures that have not been great for others. It’s best to consult with your dermatologist and get a second, third or even fourth opinion before committing to any treatment.

Is there a support group for people suffering from keloids? Yes! I love the Keloid and Hypertrophic Scars Support Group on Facebook. You’ll find a ton of member support and success stories there.

If you found my keloid treatment story helpful, please share it. Thank you for your support!

Thank you for visiting today! If you found this encouraging or informative, please connect with us on Instagram or TikTok.

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Don

Thursday 14th of December 2023

Hey Schimiggy, I just had a keloid scar removed from my chest in the exact same spot. Wasn't quite as large as yours (probably about the size of a kidney bean), but it was irritating and would get worse whenever hair would grow in. I tried the steroid injections route, but they did nothing and were too expensive. I finally asked my PCP if he could just cut it off, but he said there is a chance of it growing back. I actually mentioned your scar to him and said I didn't want it to get any bigger since it wasn't going away. So he was able to do it right there in his office and stitch it back up. I have no idea where it came from or what caused it, but I'm sure glad it's gone. Just glad I don't have to worry about it for a while.

RR

Wednesday 27th of April 2022

Thank you for sharing, as someone with chest keloids this is so helpful to see! Your scars look great!

adriana

Wednesday 2nd of December 2020

I love watching your journey and seeing how your scars have improved! Please keep posting and writing about it :)

Schimiggy

Friday 23rd of April 2021

Hi Adriana! Thanks for finding my post. I will definitely keep posting. This is so important to many people and glad there is hope for people suffering from keloids.

Ady

Sunday 26th of July 2020

I started my keloid treatment this year too. I had 2 injections in Jan and Feb, but then i went back to my hometown and lockdown happen. Missed 3 months of injection and had a small regrowth at the end of that 3 months. ( the doctor told me to come every month, or 4-6 weeks) I found a new clinic last month and just had my 4th injection this week. 1 out of 5 scars (the smallest) has flatten pretty much like the ones on your nape. The new clinic also give me silicone gel called dermatix. The doctor didnt inject the ones that have soften too, even though i feel dissatisfied because its still raised i can feel it. But i accept her advice, and just wanted to keep applying the gel. Wanted some closure about the scars so here i am. Thanks for sharing your experience, definitely will subscribe to your blogpost!

Schimiggy

Friday 23rd of April 2021

Hi Ady! Thank you for your update! I really appreciate you sharing your experience with us. Sorry you missed your injections. I definitely feel my nape ones regrowing so will need a maintenance shot during my next visit. Did you feel that the Dermatix helped you? I was not advised to do anything else beyond the laser and injections. i hope you're able to continue your treatments by now. Keep me posted I would love to hear about your progress!

Grace

Friday 22nd of May 2020

How much does it cost per session with insurance coverage?

Schimiggy

Friday 29th of May 2020

Depends on your deductible. My first visit was $180 with insurance. Every visit thereafter was only $93 each visit. My insurance plan also includes $1000 deductible paid for by employer and then additional $1000 paid out of my own pocket. After the $2000 deductible I do not pay anything beyond that.

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