Combination protocols, not single treatments.
The clinical literature is consistent: combination therapy outperforms monotherapy for keloid control. These six stacks layer treatments the way dermatologists actually plan them — a primary reduction step, a biologic adjunct, and long-term maintenance.
- Start here · Home-first protocolModerate
Non-invasive Stack
The at-home protocol — start here if you're not ready for injections yet.
Three low-risk, self-applied therapies layered into a daily routine. Highest-leverage starting point for young scars and for people who want to postpone injections.
- silicone sheets
- pressure therapy
- red light therapy
3-6 months minimum, often extended to 12 monthsView protocol → - For keloid-prone patientsStrong
Post-surgery Prevention Stack
If you are keloid-prone and heading into a planned skin procedure, the highest-leverage time to act is the weeks immediately after. This stack layers silicone, optional prophylactic steroid, and pressure to keep a new keloid from forming in the first place.
- silicone sheets
- steroid injections
- pressure therapy
- red light therapy
3-6 months of active prevention, 12-month follow-upView protocol → - Standard of careStrong
First-line Clinical Stack
The most commonly recommended starting protocol for established keloids. Pairs intralesional steroid injections with silicone-based maintenance and an optional home adjunct.
- steroid injections
- silicone sheets
- red light therapy
6-12 monthsView protocol → - Second-line protocolModerate
Steroid-resistant Stack
For keloids that have plateaued after 2-3 steroid sessions. Combines cryotherapy to soften dense scar tissue, adds 5-fluorouracil for its complementary mechanism, and keeps silicone as maintenance.
- cryotherapy
- 5 fluorouracil
- silicone sheets
- red light therapy
4-8 monthsView protocol → - Site-specific protocolStrong
Ear Keloid Stack
The classic protocol for earlobe and ear cartilage keloids — excision plus long-term pressure clips plus steroid injections. Well-supported in the literature and specifically engineered for keloids forming around piercing sites.
- surgical excision
- pressure therapy
- steroid injections
- silicone sheets
- red light therapy
6-12 months of active treatment plus 12-month follow-upView protocol → - For large or recurrent keloidsStrong
Surgical Stack
Surgical excision is high-recurrence when used alone — up to 100% in some series. This protocol pairs excision with post-op radiation and long-term silicone to bring recurrence down to roughly 10-30% in the literature.
- surgical excision
- radiation therapy
- silicone sheets
- steroid injections
- red light therapy
12-24 months including all adjuncts and follow-upView protocol →