Kenalog Steroid Injections For Keloid Scars

Last updated: September 25, 2026

Kenalog steroid injections for keloid scars are usually the first treatment a dermatologist offers, and often the only one. If you’re considering them, there are a few things worth understanding before you proceed.

First, a single injection won’t produce lasting results; effective treatment requires a long-term, repeated approach, typically over 4 to 12 months, depending on the size of the keloid scar. Second, the concentration or potency of the steroid injection is very important to your success. Third, while your dermatologist may be the one administering the injections, keloids are not necessarily one of the most common conditions they treat. They may not have extensive experience treating keloids from the beginning of treatment through the final outcome. That’s why it can be helpful to go into your appointment already knowing what you want. Fourth, the best results come from a multi-step approach, not steroid injections alone. Keep reading and I’ll walk you through the full multi step plan below.

I took this after picture next to the window, so this is what it looks like in direct natural sunlight.

I took this after picture under an overhead light in the bedroom, so this is what it looks like under a ceiling fan light.

This after picture is taken in the mirror under ceiling lighting.

The steroid your dermatologist is referring to is triamcinolone acetonide (TAC), an intralesional corticosteroid injected directly into the keloid tissue.

Corticosteroids are synthetic versions of a hormone your body already produces naturally: cortisol, made by your adrenal glands. Cortisol’s job is to regulate inflammation and immune response. When injected directly into a keloid, a corticosteroid delivers a concentrated version of that same signal, slowing down the overactive cells responsible for excess collagen production and stopping the scar from continuing to grow.

The specific corticosteroid used for keloid injections is triamcinolone acetonide, commonly sold under the brand name Kenalog. In other countries your doctor might use Kenacort. Any reputable brand will do. The steroid stays localized at the injection site rather than dispersing through the body, making it more effective at targeting the scar tissue directly.

The Importance of Kenalog Concentration in Keloid Treatment

Kenalog comes in different concentrations, which determine how potent the dose is at targeting the keloid. Your dermatologist will typically stock Kenalog-10 (10 mg/mL) and Kenalog-40 (40 mg/mL). The number refers to how many milligrams of the active drug are packed into each milliliter of liquid. A higher number means a more concentrated, more potent dose. Depending on your keloid size, quantity of keloids, and location, they may dilute the Kenalog-40 with saline and/or lidocaine to land somewhere between the two concentrations.

The most common concern your dermatologist will raise is that too strong a dose can cause skin atrophy, which is a small indentation that forms when tissue thins and sinks below the natural skin surface.

Here’s the practical reality for anyone who has lived with a painful, disfiguring keloid; mild atrophy, which is unlikely to begin with, is a far more acceptable outcome than the keloid itself. If your keloid is on your chest, shoulder, back, or anywhere other than your face, it can tolerate Kenalog-40 undiluted at full concentration. A dermatologist who insists on starting with Kenalog-10, or diluting Kenalog-40 down to the equivalent of 20 mg/mL out of an abundance of caution, is extending your treatment timeline unnecessarily and costing you both time and money in additional sessions.

The exception are keloid scars on the face or jawline. Given the visibility of the area, starting with Kenalog-10 is reasonable. From there, depending on the thickness of the keloid and how it responds, your dermatologist and you can determine whether a higher concentration is warranted.

How Many Kenalog Steroid Injections For Keloids Do I Need?

Effective keloid treatment with Kenalog requires a long-term commitment. Returning every 4 to 5 weeks consistently is what produced the best results in my experience. Keloid thickness, location on the body, and individual response to treatment all factor into the timeline, but as a general benchmark, plan for 5 to 6 injections over the first six months to establish solid progress. If the keloid is smaller and not very thick, it may flatten completely in fewer than five injections, and additional treatment may not be necessary.

If you have a thicker keloid it may take a full year to see it flattened out substantially. Continue injections every 4 to 5 weeks until the keloid is visibly reduced to near skin level or flush with the surrounding surface. At that point, understand that while significant flattening has been achieved, occasional future injections may still be needed. Keloid scars can remain dormant for extended periods before becoming irritated and resuming growth; a Kenalog-40 injection should be administered promptly at the first sign of recurrence and should make the scar go dormant once again.

Even today years later after finding success, a keloid scar will “reactivate” or “awaken” and start to grow again and I’ll have to go in for the occasional Kenalog injection.

Steroid Injections for Keloid Scars Are Only One Part Of A Three-Part Strategy

I visited countless dermatologists throughout my teens and early twenties. The reality is that many dermatologists have limited experience treating keloids and tracking successful long-term outcomes. Don’t blame the dermatologist though, keloids are not a common skin condition and they are just plain difficult to treat.

When you see a dermatologist for keloid treatment, manage your expectations accordingly. Their role is to administer the Kenalog injections. Go in with that understanding but don’t expect a whole lot more.

It’s also important to remember the nature of keloid scars: they do not have a natural stop signal. Normal scar tissue recognizes when the skin has healed and stops growing. Keloids do not. If you receive a Kenalog-40 injection in January and do nothing further for three months, by March many keloids will have returned to their original size. 

The most effective long-term strategy I’ve found for substantially reducing keloid scars, based on personal trial and error, combines three approaches: Kenalog-40 injections, daily moisturizing and consistent use of medical-grade silicone sheeting secured with Hypafix tape. Of the three components of this strategy, steroid injections make the biggest difference. If you choose only two, I recommend combining steroid injections with daily lotion application. And if you’re willing to deal with the hassle of keeping silicone sheets taped to your skin, I believe combining all three methods offers the best chance for maximum improvement.

Moisturizing daily should be part of your keloid care routine. I used Lubriderm Advanced Therapy, a thicker lotion, but you can use any moisturizer that works well for your skin. Keeping the scar moisturized can help prevent the keloid and surrounding skin from becoming dry, tight, or irritated. Dryness can make the area feel more uncomfortable and may contribute to itching and irritation, while maintaining moisture helps keep the skin barrier healthy and the scar tissue more supple.

The key is consistency. Make applying lotion part of your daily routine, just like brushing your teeth. I still moisturize the remaining areas of my keloid scars every day after showering, even years later.

Silicone sheeting helps soften scar tissue and retain moisture over the scar. It is an important adjunct to Kenalog-40 injections and will help improve overall treatment outcomes. The lotion and silicone sheeting, in addition to softening keloid tissue, can play a role in reducing discoloration. For silicone sheeting, thickness matters. Use a silicone sheet that is at least 1 mm thick, with anything up to 2 mm being equally effective. Thinner silicone sheet products commonly found in drugstores or online will not deliver results. The silicone sheet has to be adhesive. Cut the size out with scissors to match the size of the keloid scar so you don’t waste the silicone sheeting. Secure the sheet with Hypafix tape, which is the best tape I found after countless tries with other tapes. 

You can check out my article on silicone sheeting here: Silicone Sheeting for Keloid Scars

Your Daily Routine

1. Immediately after your shower, moisturize your keloid scars with lotion. Let the lotion dry a minute or two.
2. Using scissors, cut a piece of silicone sheeting to match the size of your keloid scar. Avoid wasting silicone sheeting by cutting only what you need. Apply the silicone sheet directly to the scar.
3. Cut an appropriately sized piece of Hypafix tape and apply it over the silicone sheet to secure it in place.

Amazon Hypafix Tape

4. Put on your clothes gently so you don’t inadvertently remove the tape or silicone sheet.

5. Wear the silicone sheet until you shower the next day (so effectively 20 to 24 hours each day) or at minimum overnight for 10 hours. Repeat daily. The silicone sheet you cut out can be used for three to four weeks at a time before it loses its effectiveness. If it gets greasy or dirty, run it under water and then dry it with your hands. Do not wash it daily.

Whether you have 1 keloid or 10, you have to manage your expectations and understand there are no magic bullets or quick fixes. If you apply a consistent approach over 6 to 12 months, including regular Kenalog-40 injections, daily moisturizing, and consistent use of silicone sheets, you should see tangible results.