Chest and Back Keloid Treatment: Q&A From Canada

Last updated: September 22, 2026

The following Q&A features a woman from Canada who is currently undergoing treatment for chest and back keloids. Her treatment was still in progress at the time of publication in 2026.

Keloid scar on her chest.

I’ve artificially lightened this picture above to show the keloid scar prior to Kenalog 40 mg/mL injection.

Keloid scar after one shot of Kenalog-40 and occasional use of Eclar plaster.

Chest and Back Keloid Treatment Questions and Answers

Answers may have been edited for brevity and clarity.

Question: What country are you from?

Answer: I’m from Canada.

Question: How old were you when you got your keloid scars and what caused them to form?

Answer: I have about 15 small keloids on my back that formed around age 15 to 16 when I was getting acne. I also have the one chest keloid you can see from the picture. I’m 20 now and didn’t start attempting treatment of the keloid scars until I was 17 or 18.

Question: Were you taking acne medication at the time the keloids started to form?

Answer: Yes, I was taking Accutane.

Question: What’s your heritage or ethnic background?

Answer: I’m Han Chinese.

Question: When you first sought out treatment at ages 17–18, what did you do?

Answer: I started with Kenalog 20 mg/mL injections about once a month. I continued this treatment for roughly a year, but the results were limited. Some of the keloids flattened a bit, while others showed basically no improvement. The only good thing was that the Kenalog 20 mg/mL relieved the itching. I went to study abroad so I took a break from getting the Kenalog injections.

Question: If the Kenalog 20 mg/mL wasn’t having an effect on the keloid scars, why didn’t you get a stronger concentration of Kenalog?

Answer: The doctor was cautioning me about atrophy.

Question: After returning to Canada, did you start treatment again?

Answer: Yes. I decided to go to a different dermatologist and told her the Kenalog 20 mg/mL didn’t do much at all, so she suggested we do Kenalog 40 mg/mL. I did one shot so far and the results are pretty good. That was a month ago, so I’ll go for another round of shots sometime this month.

Question: How often are you wearing the Eclar plaster?

Answer: Not that often, maybe 3 days a week. I’m just too lazy to put on the Eclar plaster every day.

Question: Have you been able to do anything to prevent new keloid scars from forming because of acne breakouts?

Answer: Yes, I monitor my acne closely and put an acne patch on each pimple, which helps it come to a head.

Comments from the editor are below:

How Acne Can Lead to Keloid Scars

It’s no secret that one of the leading causes of chest, shoulder, back, and jawline keloids is acne. For keloid-prone individuals, monitoring your acne closely and keeping it moisturized is very important. Similar to this woman in the Q&A, I also had shoulder and chest acne as a teenager that caused me to form keloids. The key is to get the acne to come to a head so it can be drained. If your acne dries out and never comes to a head, it can turn into a keloid scar within a matter of days.

I wrote an entire article on how to prevent acne from forming into new keloid scars. The link is below, but here is the short version.

Can Acne Cause Keloids? A Prevention Guide

1. Dry skin and dry acne are major problems 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? With lotion and a small silicone patch or hydrocolloid patch to cover it. You can use Hypafix tape to secure the silicone patch or hydrocolloid patch.
5. Once the pimple is softened where you can see pus forming beneath the pimple, or it has formed a whitehead, drain it. Keep it moisutrized the next few days to help the healing process.

I’ve read online that a common trend among people struggling with keloid scarring from acne is that they previously took Accutane. And, you guessed it, one of Accutane’s most common side effects is extreme skin dryness.

If you’re taking Accutane and starting to develop keloid scars, I’d consider stopping it or at minimum implementing the strategy outlined above to help prevent new keloids from forming. In my view, having keloid scars can be far more difficult and long-lasting than dealing with acne itself.

Kenalog Steroid Injections for Keloids

In my own experience and opinion, undiluted Kenalog 40 mg/mL injections were necessary to make serious progress in flattening my chest and shoulder keloid scars.

It’s unfortunate that this woman spent an entire year receiving Kenalog 20 mg/mL injections without seeing any results. Both her time and money were wasted. She explains that her doctor was concerned about causing atrophy, meaning the skin could become thinner or develop a slight indentation. How can the injections cause atrophy if the keloid is still raised and bulging above the surrounding skin? Atrophy may be a minor concern when Kenalog 40 mg/mL continues to be injected after the keloid has already substantially flattened. If the scar is still raised above the surrounding skin, you do not need to be worried about atrophy or a slight indentation. For those of us with keloid scars that are ugly, painful, and embarrassing, atrophy is the least of our concerns.

Based on my experience, if your keloid is located anywhere on your body other than your face, opt for undiluted Kenalog 40 mg/mL. No saline or lidocaine. This simply means asking your doctor not to mix the Kenalog with anything else. In other words, the Kenalog would be injected undiluted, directly from the vial into the keloid scar.

Kenalog is a brand name for the corticosteroid triamcinolone acetonide (steroid injections for keloid scars). In the United States, Kenalog is the more commonly used brand among dermatologists, but any reputable brand will do. Kenacort is also a common brand used in other countries. Triamcinolone acetonide is available in different concentrations, commonly ranging from 10 mg/mL to 40 mg/mL.

The appropriate concentration depends on the keloid’s size, thickness, and location. A concentration of undiluted 40 mg/mL is often used for thicker keloids, while lower concentrations may be preferred for smaller, thinner, or facial keloids.

For further information about using triamcinolone acetonide (steroid injections for keloid scars) you can check out this article:

Kenalog Steroid Injections For Keloid Scars

Eclar Plaster for Keloid Scars

Many people have shared their positive results using Eclar plaster. Wearing a patch that you have to cut out each day can be a bother, but if you’re consistent and wear the patch for months and consistently wear it each day, I believe you’ll see results. I’ve written an in-depth article on it you can find below:

Eclar Plaster for Keloid Scars