Introduction
Keloids are firm, rubbery lesions or shiny, fibrous nodules that grow beyond the boundaries of the original skin injury. They develop when the body overproduces collagen during the healing process, causing excessive scar tissue to form. Keloids can develop after surgery, burns, acne, piercings, scratches or other skin injuries. They do not regress over time and can continue to grow larger. Keloids tend to be more common in people with darker skin tones. There is no definitive cure for keloids, but treatment can help improve their appearance and symptoms. Using ice is one home remedy some people try to flatten or reduce the size of keloids.
What are keloids?
Keloids are a type of raised scar that grow beyond the original wound or injury site. They form when collagen and other skin tissue proliferates excessively during the healing process. Keloids can grow larger over time and often have an irregular shape. They are firm, rubbery lesions that may be flesh-colored, pink, red, or darker than surrounding skin. Keloids tend to be itchy, painful, or tender. They often cause discomfort due to their size, texture, and location. Keloids can develop after any type of skin trauma, such as:
- Cuts, scratches or surgical incisions
- Burns or other skin injuries
- Body piercings
- Insect bites
- Vaccinations
- Acne
- Chickenpox
People with darker skin tones are more likely to develop keloids, especially African Americans, Hispanic/Latinos and Asians. There may be a genetic component as keloids tend to run in families. Keloids can occur at any age but are more common between the ages of 10 and 20. They are more prevalent in wounds on the upper chest, shoulders, earlobes and cheeks, but can occur anywhere on the body.
Do keloids go away on their own?
Keloids do not typically go away on their own without treatment. They are benign skin growths but can continue to enlarge over time and often persist indefinitely unless removed. Some keloids may exhibit phases of active growth followed by quiescence, but they rarely resolve spontaneously. The collagen and scar tissue buildup remains excessive during healing.
Keloids also tend to recur after surgical removal, particularly if the incision site was not closed correctly or the underlying scar tissue was not completely excised. Recurrence rates after surgical removal may be as high as 80-100% without adjuvant treatment. For these reasons, it is advisable to pursue treatment for symptomatic, enlarging or bothersome keloids. Doing nothing usually results in the keloid remaining present long-term.
What are the treatment options for keloids?
There are various treatment options that may help flatten or reduce keloids, including:
- Corticosteroid injections – Corticosteroids help suppress inflammation and collagen production.
- Cryotherapy – Freezing keloids with liquid nitrogen helps damage scar tissue.
- Silicone gel sheeting – Worn over keloids to hydrate and compress scar tissue.
- Laser therapy – Laser energy helps reduce scar tissue.
- Radiation – Low-dose radiation prevents re-growth of cells.
- Surgery – Excising the keloid and closing the wound with care. Often combined with other treatments.
- Interferon injections – Help control collagen production.
- 5-FU injections – 5-fluorouracil stops cell growth and collagen production.
- Bleomycin injections – Antibiotic that blocks collagen formation.
- Compression therapy – Elastic wraps or tape to apply pressure.
The most effective approach is often a combination of therapies used together, such as surgery combined with radiation or steroid injections. Home remedies like using ice may provide some temporary symptom relief but do not treat the underlying scar tissue growth. Discuss all treatment options with your dermatologist to determine the best plan for your keloids.
Using Ice on Keloids
Can you freeze off keloids with ice?
Using ice or cold therapy is not an effective way to permanently remove or “freeze off” keloids. Icing keloids may help provide temporary relief of pain, inflammation and itchiness by numbing the area. But it will not flatten keloids or get rid of the excess scar tissue. At most, the cold temperature may temporarily shrivel the keloid a bit. Once you stop icing, the keloid will return to its original size and appearance.
Freezing keloids with liquid nitrogen cryotherapy performed by a medical professional is an approved treatment method. Liquid nitrogen reaches temperatures as low as -320°F and can permanently destroy cells. Research shows cryotherapy combined with corticosteroid injections can significantly flatten keloids in many cases. But ice cubes or cold compresses do not get cold enough or treat the area for long enough to freeze away scar tissue. Ice alone has no lasting impact on the size of keloids.
Does cold temperature help flatten or shrink keloids?
There is some limited evidence that cold temperatures may temporarily help flatten or soften keloids slightly while the ice is applied. The cold causes localized vasoconstriction, reducing blood flow to the area. This helps decrease inflammation, swelling and fluid within the scar tissue, making the keloid feel softer and flatter temporarily.
However, this is a temporary effect and keloids return to their original state after icing stops. Using ice or cold therapy alone provides minimal long-term improvement in the overall size, texture or shape of keloids according to most dermatologists. It may provide symptom relief but does not remove the excessive scar tissue. Freezing temperatures must be more extreme (cryotherapy) to achieve longer-lasting scar flattening effects.
Should you ice new keloids to prevent growth?
Icing a new keloid shortly after it forms has minimal impact on preventing its growth or spread. Early icing may help reduce pain, itching and inflammation during initial keloid development. However, it will not stop the scar tissue from proliferating excessively as the skin heals.
To potentially thwart the growth of newer keloids, the most effective early treatments are corticosteroid injections and silicone gel sheeting. Steroid injections help curb inflammation and shut down the runaway cell activity. Silicone sheets hydrate the wound, reduce collagen production and may prevent the scar from expanding. Icing alone does not stop the biological processes that cause keloid enlargement over time.
Does cold therapy reduce the risk of keloid recurrence after surgery?
Using cold compresses or ice packs after keloid surgery does not appear to significantly reduce the risk of the keloid recurring. Keloids have a high rate of recurrence after surgical removal without additional adjuvant therapies. This is because surgery alone does not address the underlying biological mechanisms causing aggressive regrowth.
To lower recurrence risk after surgery, radiation therapy is often administered immediately after excision while the surgical site is healing. Other options include corticosteroid injections, silicone gel sheeting and sometimes chemotherapy medications. Consistently cooling the surgical site with ice has not been shown to lower recurrence compared to these medical treatments that target and disrupt scar tissue regeneration.
Should you put ice on a keloid every day?
Daily ice application could help temporarily relieve keloid symptoms like pain and itching. The cold temperature may momentarily shrink the lesion and slow inflammation. However, putting ice directly on keloids daily is unlikely to result in any permanent size reduction or prevent the keloid from continuing to grow over time.
Excessive icing could also potentially damage healthy skin tissue. It is best to reserve icing just for flare-ups or when the keloid is especially painful. Ice should be wrapped in cloth and never applied directly. Most dermatologists recommend limiting icing to no more than 20 minutes at a time, 1-2 times per day. Combining ice with proven medical scar treatments is more likely to yield lasting improvements in keloid flattening and symptom relief.
Are there risks to icing or freezing keloids at home?
Icing keloid scars at home only using ice cubes or cold compresses carries minimal risks when done carefully and in moderation. Potential side effects may include:
- Temporary numbness, tingling, or darkened skin
- Blistering or frostbite if ice is applied directly for too long
- Damage to healthy tissue surrounding the keloid
- Redness, discomfort or sensitivity after removing ice
To avoid damage, always wrap ice in a cloth before applying to keloids rather than using direct skin contact. Limit icing to less than 20 minutes at a time. The goal is to cool the area, not freeze it. Avoid using frozen spoons or other objects that could concentrate pressure and cold on one spot. If skin becomes discolored or blistered, take a break from icing and consult a doctor.
Prolonged, frequent icing that is too intense could potentially cause skin injury without providing meaningful long-term benefit for improving keloid scars. Use ice appropriately as a temporary complement to proven medical scar treatments.
The Effectiveness of Icing Keloids
Here is a table summarizing the effectiveness of using ice therapy for different types of keloids:
| Keloid Type | Does icing flatten keloids? | Does icing reduce symptoms? | Does icing prevent keloid recurrence after removal? |
|---|---|---|---|
| Newer keloids | Minimally effective | May temporarily reduce pain/itching | Not effective for preventing regrowth |
| Established keloids | Minimally effective | May temporarily reduce symptoms | N/A |
| Keloids after surgical removal | Not effective | May temporarily reduce pain/discomfort | Not effective for reducing recurrence |
As the table shows, icing or freezing keloids at home with ice cubes provides only minimal, temporary benefit in flattening keloid scars or permanently preventing their recurrence. It may temporarily relieve painful symptoms. But ice alone does little to halt underlying keloid growth and collagen proliferation.
Conclusion
Applying ice or cold compresses to keloid scars may provide minor temporary symptom relief but is largely ineffective for permanently reducing the size of keloids or preventing their recurrence after surgical removal. To flatten and shrink keloids long-term requires freezing temperatures colder than ice can provide. Evidence shows the optimal approach combines cryotherapy, steroid injections, radiation, silicone gel sheeting and/or surgical excision based on the individual case. Most dermatologists view icing keloids at home as an adjuvant treatment at best. While generally safe when used carefully, ice alone rarely resolves keloids or their associated symptoms permanently without additional proven medical scar treatments.
