Can Acne Cause Keloids? A Prevention Guide.

Last updated: September 22, 2026

This article is based on my personal experience preventing acne from turning into keloids. I’m not a doctor, and this should not be taken as medical advice.

Can acne cause keloids? Yes. It’s one of the leading causes of keloid scarring.

If you want to stop getting new keloid scars from acne breakouts, this article is for you. 

I got my first keloid scar at age 15 from acne on my chest, and it took me a long time to figure out how to prevent new acne from forming new keloids. Once I figured out how to manage my acne, I reduced new keloid formation by 99%.

First, a quick medical explanation of what’s happening: 

When acne develops it can damage the surrounding skin and trigger the body’s wound healing response. In most people, this process resolves without producing a raised scar. But in individuals who are predisposed to keloids, the repair process can become overactive.

Fibroblasts, the cells responsible for producing collagen, go into overdrive and create more collagen than the skin needs to heal. This excess collagen builds up in dense, disorganized bundles that extend beyond the boundary of the original acne lesion.

Over weeks or months, the scar thickens into the raised, firm and often rubbery growth we recognize as a keloid. Unlike a normal scar, which usually softens and fades over time, a keloid can continue growing beyond the original wound.

How My Acne Turned into Keloid Scars

Here is what happened over the years when I formed the most keloids on my chest or shoulders.

A new pimple would form, red and irritated, but not poppable. We all know what it’s like to have a pimple that hurts but won’t come to a head. My skin was often dry from showering twice a day without moisturizing, which only aggravated the acne further.

No whitehead would appear on the pimple. Instead, over a span of days or week, the pimple would harden into a small scar, and then continue growing larger over the following months and years.

The key factor was moisture and keeping the pimple tissue soft.

The goal is getting an active pimple to a point of softness where it can be drained, or heal naturally. 

Allowing my acne to heal on its own just resulted in more keloid scars. I had to develop a few steps that would prevent new keloids from forming.

Here is the short version for those who want conventional, effective advice.

1. Dry skin and dry acne are major accelerators for those prone to keloid scarring.
2. If a pimple forms without a whitehead, keep it moisturized and soft so it does not harden and turn into a keloid scar.
3. Keeping the pimple moisturized and soft helps it form a whitehead or pus beneath the surface.
4. How do you keep the pimple moisturized? Apply lotion, let it absorb, and attach a silicone or hydrocolloid patch to cover it. You can use Hypafix tape to secure the silicone sheet or hydrocolloid patch.
5. After wearing the patch for a day or so, the pimple may soften and develop a visible whitehead or pus beneath the surface. Drain it and then keep it moisturized for the next few days to help the healing process.

How I Prevented Acne From Developing Into Keloids

I need to point out that this additional step in my process, which I describe below, is rather unconventional and is not medical advice. I personally had success with it, but this is just one person’s experience.

Before showering each day, I’d examine my chest and shoulders closely in the mirror and identify any new acne. If any acne was clearly ready to be drained, I would do so with my fingers. The problem came from acne where the pus hadn’t fully surfaced and squeezing the acne with my fingers would only aggravate the tissue.

Pus can sit just beneath the surface of a pimple without forming a whitehead, making it difficult to drain. Squeezing it with your fingers is ineffective unless there is a visible whitehead. You may be asking yourself, “Why mess with the acne at all?” Remember, allowing my acne or pimples to heal or go away on their own is what led to my keloid scars in the first place. The only alternative was to take some kind of action to interrupt the progression from acne to keloid formation.

Those with cystic or aggressive acne on the chest and back face two common problems. First, these pimples often don’t form a whitehead. You can have a painful, inflamed nodule sitting on your chest or back for 3 days with no signs of healing. Second, acne on the shoulders and back can be hard to reach.

Back to the pre-shower skin examination. You find a new pimple with no obvious whitehead. Press gently around it with your fingers to assess whether fluid is forming beneath the surface. If there are no signs of trapped fluid or pus, note it and proceed to your shower. DO NOT force draining a pimple if it’s not ready; you’ll only irritate it.

If however, you can see fluid trapped beneath the skin but the pimple will not easily pop with your fingers because there is no prominent whitehead, this is where the X-Acto knife is helpful. Slowly and carefully introduce just the very tip of the blade into the pimple at the point where the fluid is most concentrated. This is not a stab. It is a controlled, gradual entry to release the trapped pus. Below is a photo of the blade itself, detached from the handle. You are using only the tip illustrated by the circle.

If you’re in the U.S. here are two websites you can check out the X-Acto or utility knife:

X-Acto Knife Walmart U.S.

Hobby Utility Knife Home Depot

Once you have punctured the pimple, set the X-Acto knife down and apply pressure with your fingers to bring the pus to the surface. A small amount of blood will drain as well; that is normal. If the purulent contents (the white pus) release and the pimple drains fully, it’s been successful.

You’ve taken your shower and dried off. For any acne you successfully drained before your shower, make sure it gets a generous layer of lotion. I used Lubriderm Advanced Therapy for its thickness and durability, but any thick, quality lotion works. Every day I applied it across my entire chest, shoulders, and upper back.

This accelerates healing of the recently opened tissue. If the acne was particularly bad or you feel the fluids weren’t fully drained, follow the additional steps outlined in the paragraph below. Otherwise, lotion alone is sufficient and the acne will heal completely within a few days.

For any pimple that was NOT ready to drain prior to your shower, do not force “popping or draining” if you can’t see any fluid beneath the skin. Do not squeeze it with your fingers or use the X-Acto knife. Apply lotion immediately after your shower and then cut a piece of silicone adhesive sheet to cover it. Size the piece to match the pimple; a half-inch pimple gets a half-inch piece. THIS CREATES AN OCCLUSIVE SEAL THAT TRAPS MOISTURE AND KEEPS THE TISSUE SOFT. Secure the silicone with Hypafix tape to keep it in place, then carefully put your shirt on to avoid removing the dressing. 

A day later, before your next shower, remove the silicone sheet. In most cases, the combination of lotion and occlusive coverage from the silicone sheet has softened the pimple to the point where either a whitehead is now visible or fluid is clearly present beneath the surface under pressure. If the pimple is ready, use the X-Acto knife or your fingers to drain it. Once drained, it will heal. Continue applying lotion daily to support the best healing environment.

If the white pus still didn’t drain, proceed with your shower and repeat the same protocol: lotion, let it absorb, silicone sheet, Hypafix tape. By day two, the pimple will almost always be ready to be drained.

Keloid Prevention Summary

When it comes to keloid prevention, dermatologists often give advice that sounds reasonable but is not always practical for people who are keloid prone. They may tell you not to touch or interfere with your acne and to let it heal naturally. They may also say the best way to prevent keloids is to prevent acne from forming in the first place through medication.

For people who form keloids easily, letting inflamed acne “heal on its own” can be exactly how a keloid starts. And for people who are acne prone, preventing every breakout is not realistic.

If you’re getting acne on a regular basis, keep these points in mind:

• Apply a thick, quality lotion every day immediately after your shower wherever you’re prone to getting acne.
• If you have a pimple this isn’t coming to a head or forming pus beneath the surface, you have to intervene and soften it by locking in moisture.
• Apply a silicone or hydrocolloid patch over the pimple. Typically within one day or so the pimple will have softened to a point where the pus is visible beneath the surface. Once it’s ready, drain it with your fingers or an X-Acto knife.

Once I realized that keeping my acne moisturized was the key, and found the right combination of lotion and silicone sheets to keep my skin and acne flare ups soft, I reduced new keloid formation by 99%.

If you have existing keloids that formed from acne on your chest, back, shoulder or jawline, check out these articles:

Chest Keloid Treatment

Shoulder Keloid Treatment

Kenalog Steroid Injections for Keloids

Silicone Sheeting for Keloid Scars

Eclar Plaster for Keloid Scars