Clear & even skin · 12 weeks
Keloid & Scar Prevention (Piercing & Surgery)
If you or your family form keloids, plan piercings and surgery carefully and protect every new wound for 3 months. Parents can use it after a child's ear piercing.
- Length
- 12 weeks
- For
- Women, Men, Children (with a parent)
- Evidence B
- Good evidence: at least one controlled trial
- What to expect
- Silicone from wound closure for at least 2–3 months. Early keloid signs (itch, firmness, growth) usually show at 1–3 months.
The goal: A lower chance of a raised scar, and early treatment if one starts.
Silicone has a low-quality Cochrane review (B) and guideline support; piercing-age advice is from a small survey (C). Keloids are much more common in African skin.
Start this program
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The plan
Week 1
Plan & start
Know your risk; tell your surgeon; start silicone once the wound is closed.
Prevention starts before and immediately after the wound (scar guidelines).
Morning
Sunscreen or cover on the scar
SPF 30+ on exposed healing scars every morning, or cover with clothing or a plaster.
Why: Healing scars darken in the sun, especially on darker skin.
Evening
Silicone gel or sheet on the healed wound
Start once the wound is closed and dry (no scab or stitches). Gel: thin film twice daily, let it dry. Sheet: wear 12–24 hours a day, wash it daily, remove if the skin gets a rash. Continue at least 2–3 months; longer if keloid-prone. Cheaper sheets can be cut to size and reused after washing. Safe in pregnancy and for children.
Why: Cochrane found weak, low-quality evidence that silicone sheeting reduces abnormal scarring in high-risk people; international scar guidelines still recommend it as first-line prevention.
Habits
Know your keloid risk before piercing or surgery
If you, a parent or a sibling has keloids, think twice about new piercings and cosmetic surgery; avoid cartilage or upper-ear piercings. One small survey (mostly Black participants) found keloids were more common when ears were pierced at age 11 or older, so parents may prefer early piercing or none.
Why: Keloids are far more common in people of African descent and can follow even tiny wounds.
Lane, Waller & Davis. Age of ear piercing and keloid formation (Pediatrics, 2005; HealthDay summary)
Tell every surgeon and nurse
Say "I form keloids" before any operation, including caesarean section, so they can plan wound closure and early follow-up.
Why: Planned closure and early treatment lower the chance of a raised scar.
No home removal
Never tie threads, cut, burn or put caustic or herbal pastes on a keloid.
Why: Any new injury makes a keloid return larger.
Food
Hydration
Water with each meal and whenever thirsty; more in heat and harmattan.
Why: Supports overall health; skin hydration is mostly about the barrier, so pair water with moisturiser.
Weeks 2–8
Protect the wound
Silicone every day; sun protection; hands off.
Silicone hydrates and calms the healing scar during the months keloids form.
Morning
Sunscreen or cover on the scar
SPF 30+ on exposed healing scars every morning, or cover with clothing or a plaster.
Why: Healing scars darken in the sun, especially on darker skin.
Evening
Silicone gel or sheet on the healed wound
Start once the wound is closed and dry (no scab or stitches). Gel: thin film twice daily, let it dry. Sheet: wear 12–24 hours a day, wash it daily, remove if the skin gets a rash. Continue at least 2–3 months; longer if keloid-prone. Cheaper sheets can be cut to size and reused after washing. Safe in pregnancy and for children.
Why: Cochrane found weak, low-quality evidence that silicone sheeting reduces abnormal scarring in high-risk people; international scar guidelines still recommend it as first-line prevention.
Habits
Pressure earrings (only after a doctor removes an earlobe keloid)Doctor or pharmacist
If a doctor removes an earlobe keloid, they may fit pressure earrings; wear them exactly as instructed. Your doctor or pharmacist will advise the dose and how long.
Why: Pressure after removal helps stop the keloid returning (case-series evidence).
No home removal
Never tie threads, cut, burn or put caustic or herbal pastes on a keloid.
Why: Any new injury makes a keloid return larger.
Weekly progress photo
Same place, same daylight by a window, no filter, no makeup; front, left and right.
Why: Change is slow; consistent photos show progress memory cannot.
Food
Hydration
Water with each meal and whenever thirsty; more in heat and harmattan.
Why: Supports overall health; skin hydration is mostly about the barrier, so pair water with moisturiser.
Weeks 9–12
Early-warning check
Keep silicone going; weekly feel and photo; doctor early if it rises.
Small, early keloids respond best to treatment.
Morning
Sunscreen or cover on the scar
SPF 30+ on exposed healing scars every morning, or cover with clothing or a plaster.
Why: Healing scars darken in the sun, especially on darker skin.
Evening
Silicone gel or sheet on the healed wound
Start once the wound is closed and dry (no scab or stitches). Gel: thin film twice daily, let it dry. Sheet: wear 12–24 hours a day, wash it daily, remove if the skin gets a rash. Continue at least 2–3 months; longer if keloid-prone. Cheaper sheets can be cut to size and reused after washing. Safe in pregnancy and for children.
Why: Cochrane found weak, low-quality evidence that silicone sheeting reduces abnormal scarring in high-risk people; international scar guidelines still recommend it as first-line prevention.
Habits
See a doctor early if a scar starts to riseDoctor or pharmacist
If a scar becomes itchy, firm, raised or grows beyond the wound, see a doctor early. Steroid injections and other treatments work best on small, early keloids. Your doctor or pharmacist will advise the dose and how long.
Why: Early keloids respond better and need fewer treatments; guidelines recommend early intervention.
Weekly progress photo
Same place, same daylight by a window, no filter, no makeup; front, left and right.
Why: Change is slow; consistent photos show progress memory cannot.
No home removal
Never tie threads, cut, burn or put caustic or herbal pastes on a keloid.
Why: Any new injury makes a keloid return larger.
Food
Hydration
Water with each meal and whenever thirsty; more in heat and harmattan.
Why: Supports overall health; skin hydration is mostly about the barrier, so pair water with moisturiser.
Milestones
Your weekly check-in
Ask yourself these once a week. If an answer worries you, stop and see a doctor or pharmacist.
Stop and see a doctor if
- A scar growing beyond the original wound: see a doctor early
- Pain, pus or redness (possible infection): stop silicone and see a doctor
- A rash under the sheet
- Never use caustic, herbal or thread "removal" on a keloid
In an emergency, call 112112999911911.
Sources
- O'Brien & Jones. Silicone gel sheeting for preventing and treating hypertrophic and keloid scars (Cochrane, 2013; CD003826)
- Gold et al. Updated scar management practical guidelines: non-invasive and invasive measures (2014) (verify)
- Meaume et al. Management of scars: updated practical guidelines and use of silicones (verify)
- Lane, Waller & Davis. Age of ear piercing and keloid formation (Pediatrics, 2005; HealthDay summary)
- AAD: Sunscreen FAQs
Education, not diagnosis. This plan cannot examine you; pending physician review where marked.
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