Keloids are more than just scars-they’re stubborn, raised marks that can grow well beyond the original site of a cut, piercing, or injury. For many people, keloids are uncomfortable, sometimes itchy or painful, and often a source of self-consciousness. But what can be done when a scar refuses to fade?

One of the most widely used treatments is an injection called Kenalog, the brand name for triamcinolone acetonide, a type of corticosteroid. For decades, dermatologists have turned to Kenalog to help patients manage keloids that won’t go away on their own.

How Does Kenalog Work?

Kenalog is not a cream or a pill, but a medicine injected directly into the keloid. Its job is to calm the body’s overactive healing response, which is what causes keloids to form in the first place. By reducing inflammation and slowing the production of collagen-the protein that makes scars thick and raised-Kenalog helps flatten and soften keloids over time.

Treatment usually involves a series of injections, spaced a few weeks apart. While the process is quick, the results can take several months to fully appear.

Kenalog Dosages: What’s the Difference?

Kenalog comes in different strengths, most commonly Kenalog-10 (10 mg/mL) and Kenalog-40 (40 mg/mL). The number refers to how many milligrams of the active ingredient are in each milliliter of the injection7.

  • Kenalog-10 (10 mg/mL):
    Used when lower doses are needed, for smaller scars or more gradual dosing. This allows for finer control, especially in delicate areas.
  • Kenalog-40 (40 mg/mL):
    Much more concentrated, so a higher dose can be delivered with a smaller injection. This is often preferred for keloid treatment, as it allows effective dosing with less fluid, reducing discomfort and tissue stretching7.

Typical dosages for keloids and other uses:

  • For small joints or small areas: 2.5–5 mg (up to 10 mg)
  • For larger joints or larger scars: 5–15 mg (up to 40 mg)
  • For intramuscular injections (for certain conditions): 20–80 mg, depending on the condition and doctor’s judgment127.

Your doctor will decide which strength and dosage is best for you, based on the size and thickness of your keloid and your overall health.

The Benefits

For many, Kenalog injections offer a welcome alternative to surgery. The procedure is fast, doesn’t require stitches, and can be performed right in the doctor’s office. Most patients notice their keloids becoming flatter, softer, and less noticeable. Symptoms like itching or tenderness often improve as well.

The Risks

No treatment is without its downsides. Kenalog injections can cause temporary pain or swelling at the injection site. Some people notice their skin becomes lighter or thinner where the medicine was injected, and in rare cases, small dents can appear. There’s also a chance the keloid will return-studies suggest that about one in three keloids come back within a few years, even after treatment.

Serious side effects are rare, especially when the injections are given by an experienced professional. Still, it’s important to watch for signs of infection or unexpected changes in your skin, and to keep your doctor informed.

Alternatives to Consider

Kenalog is just one tool in the dermatologist’s kit. Other options include:

  • Silicone gel sheets or creams, which can help flatten scars over time.
  • Pressure therapy, using special bandages or earrings to gently compress the keloid.
  • Laser treatments, which target the scar’s redness and thickness.
  • Cryotherapy, which freezes the keloid to shrink it.
  • Other injectable medications, sometimes used alongside Kenalog.
  • Surgical removal, often combined with other treatments to prevent recurrence.
  • Prescription creams like imiquimod, used after surgery to reduce the risk of the keloid returning.

The Bottom Line

Kenalog injections remain a mainstay for treating keloids, offering hope to those frustrated by scars that just won’t fade. While the treatment is generally safe and effective, it isn’t perfect-side effects are possible, and keloids can return. Fortunately, a variety of alternatives exist, and a dermatologist can help tailor a plan that’s right for you.

If you’re struggling with a keloid, don’t hesitate to seek expert advice. With the right approach, it’s possible to find relief-and perhaps, a little more confidence in your own skin. skin.