I formed a keloid scar from my vertical incision from colon surgery a year after my hyst. With my DR's guidance, I tried several different treatments. First we tried Vitamin E cream. It felt good but didn't do much for the scar. It still hurt and sometimes itched. The next thing he had me try was the scar sheets you can now buy OTC at drugstores (there are several brands). These are silicone sheeting that you cut and fit over the scar and wear pretty much continuously. They do tend to soften and lighten the scar slightly, due to better moisture retention. Still, the result was not what I was hoping for, or even close.
Next, he sent me to a plastic surgeon, who prescribed Aldara cream. Aldara is an immune suppressor that is meant for treatment of genital warts
; however, keloid scars are an off-label use for it. It was very expensive, but it did lighten and flatten the scar more. After a few months, though, it stopped making it improve, and in fact irritated the scar (this is a known side effect of using it long term).
Then, I went to a website called worldwide wounds, which is a board for health care providers dealing with nasty wound issues. Unfortunately, their message boards are in the process of being redesigned, so it's hard to find anything on there right now. However, I found on that site numerous recommendations for the use of a nasty smelling paste called Hei Ba Gao on keloid scars. I tried it, and while it was awful to use, it was the only thing that stopped the scar from itching and hurting all the time. I used it for a couple of months and then it, too, irritated the scar too much.
The plastic surgeon told me at that point that the only other option left to me was to have the cortisone injections in the scar, which he told me were quite painful (I believe it). I decided to hold off on that.
It's now been three years since that surgery, and in the last year, I've noticed a big improvement in my scar. It is much lighter, though still by no means invisible. It doesn't hurt or itch at all anymore. I still use a little vitamin E/allium (allium is the active ingredient in mederma) scar gel from the health food store on it every day, because it keeps it feeling soft.
I've also noticed there is a new product out now, called Super Cop, which is a copper peptide cream for scar reduction. Here's a link to a review of the product:
I would ask your DR before trying it, as, like the Hei Ba Gao, it can also irritate the skin with long term use.
You didn't mention this option, but I thought I would, for completion's sake. Plastic surgeons can do scar revision surgeries where they remove the scar and let it re-heal. However, if you have a keloid, there is a good chance that you'd just form another one. I was told I was not a good candidate for the procedure but it can be great in cases where there's a large scar because of infection in the initial incision. My plastic surgeon actually uses the Aldara cream during early healing when he does scar revisions and says it can result in a lower incidence of keloids.
But, as far as I am concerned, I've had enough surgeries already, and surgery for cosmetic purposes isn't high on my to-do list.
I hope this helps.