Newer injectable options for resistant keloids

Corticosteroid injection is the keloid workhorse, but some keloids resist it or relapse, and the field has expanded the injectable options for these stubborn cases.

Dermatologists treating resistant keloids increasingly reach for combinations and alternatives: injecting agents that interfere more directly with the abnormal cell activity and collagen production, sometimes alternating or combining them with steroids to improve response while limiting steroid side effects like skin thinning and lightening. Cryotherapy paired with injection, and structured multi-session protocols, round out the approach. Underpinning all of this is deepening research into the molecular signals that drive keloid overgrowth, which is steadily pointing toward more targeted therapies.

Clinics that follow the literature tend to use these combination and alternative-injectable strategies rather than repeating steroid alone indefinitely, an approach reflected in the case discussions leading dermatology practices publish. For a patient whose keloid has stalled on steroids, the meaningful message is that resistance is not the end of the road, a dermatologist experienced with these newer intralesional options often has further, effective moves to try.

Related reading: Why keloids love the chest, shoulders, and back and Cryotherapy for keloids: freezing the overgrowth.