At the injury
The Skin Overreacts
A cut, piercing, spot or operation starts the healing process, and in some people it can go into overdrive.
Lowering the Risk of a Keloid Growing Back
Removing a keloid with surgery alone often leads to a larger one, because the skin that heals the wound can overreact all over again. Low-dose radiotherapy given within days of surgery is a recognised way to reduce that risk. Dr Shaffer plans it together with your surgeon.
Does This Sound Familiar?
Radiotherapy may be worth discussing if any of these sound like your keloid:
- A firm, raised scar that has spread beyond the edges of the original wound
- It itches, aches or feels tender, especially while it's still growing
- It has come back after injections or after being cut out
- An operation to remove a keloid is on the horizon, and you want the best chance of it not coming back
If you recognise yourself here, an assessment can show whether radiotherapy could help. If a skin lump bleeds, breaks down or changes quickly, see a doctor before anything else.
Why Keloids Keep Coming Back
Most scars flatten and fade as the skin repairs itself. In a keloid, the repair process doesn't switch off. The skin keeps laying down collagen, so the scar becomes thick, firm and raised. It also spreads beyond the edges of the original wound and, unlike an ordinary raised scar, doesn't shrink back on its own. Almost any skin injury can trigger one, including surgery, piercings, acne, burns, vaccinations and insect bites. Keloids most often appear on the chest, shoulders, upper back, chin, neck and ears. They're more common in people with darker skin, in people between about 10 and 30 years old, and in families where others have had them. Cutting one out is an injury in itself, which is why keloids so often return.
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Weeks to years later
The Scar Keeps Growing
A keloid can take weeks, months or even years to appear. It then thickens and spreads, and may itch or hurt while it grows.
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After removal
The Risk Is Highest
Removing the keloid creates a new wound, so the same process can start again. Radiotherapy at this point is thought to calm the cells that make scar tissue.
Where Your Keloid Is Matters
Keloids behave differently depending on where they form, and the radiotherapy schedule is adjusted to match. The areas Dr Shaffer sees most often include:
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Ear and Earlobe
Ear keloids often follow a piercing, and they tend to respond well to treatment. In pooled studies, the ear had the lowest rate of regrowth of any site. A shorter, less intensive schedule is generally used for the earlobe.
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Chest and Upper Back
These areas are under constant tension from everyday movement, which makes keloids here some of the most stubborn. Pooled studies show a higher rate of regrowth on the chest and trunk, so a slightly longer schedule is usually chosen. Nearby tissue such as the breast is shielded where possible.
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Shoulders and Arms
Keloids here are common after vaccinations, injuries and surgery, and the skin moves a lot. Dr Shaffer looks at the size of the keloid and how it has behaved in the past, then advises whether radiotherapy after removal is likely to be worthwhile.
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Neck, Chin and Other Areas
Keloids can form almost anywhere, including the neck, chin, jaw and legs. Treatment on the neck is planned with particular care because the thyroid sits close by. Dr Shaffer will explain whether the benefit justifies it for you.
Treatment Options for Keloids
No single option suits all keloids. The right choice depends on the size and position of the scar, how long you've had it, how much it bothers you and what you've already tried.
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Prevention and Self-Care
If you're prone to keloids, avoiding unnecessary piercings, tattoos and elective skin procedures lowers the chance of a new one forming. Silicone gel or dressings are often suggested, and treating acne early reduces the scarring it leaves behind. These measures can ease a keloid but rarely get rid of one that's already established.
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Injections, Freezing and Laser
Steroid injections soften and flatten a keloid and can ease itching. Freezing (cryotherapy) and laser treatment are also widely used, and laser before steroid injections may help the injections work better. However, the benefit often doesn't last. About half of keloids treated with steroid injections grow back, and the injections can change the colour of the skin.
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Surgery on Its Own
Removing a keloid with an operation alone is rarely a lasting answer. In published studies, between roughly half and nearly all keloids grew back. The NHS says surgery alone isn't usually recommended because the scar is likely to return bigger.
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Surgery With Low-Dose Radiotherapy
Taking the keloid out and then giving a brief course of low-dose radiotherapy to the wound is recognised in the Royal College of Radiologists' guidance as giving a fairly low rate of regrowth. In pooled studies, around 1 in 5 keloids returned, with lower rates on the ear and higher rates on the chest. It isn't a guarantee, but it meaningfully lowers the odds for a keloid that keeps coming back.
What Treatment Involves
Radiotherapy for a keloid uses low-energy X-rays or electrons that act only on the skin and the tissue just beneath it. The total dose is a fraction of what's used in cancer treatment. It targets the surgical scar while the wound is healing, when a keloid is most likely to return.
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Assessment
Dr Shaffer examines the scar closely, asks about its history and the treatments you've had, and reviews any photographs or notes from your surgeon or dermatologist. He then gives you an honest opinion on whether radiotherapy is likely to be worthwhile.
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Planning
Because timing matters, the operation and radiotherapy are arranged together with your surgeon, so treatment can begin within a day or two of the keloid being removed. On the day, the scar is marked and, where needed, the surrounding skin is shielded.
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Treatment
You'll have a small number of very short outpatient sessions, usually between one and four depending on where the keloid is. You lie or sit still while the machine is positioned over the scar, and you won't feel anything.
- sessions, depending on the site
- One to four
- sessions, depending on the site
- each, with no pain
- A few minutes
- each, with no pain
- of surgery
- Within 1–3 days
- of surgery
- review after treatment
- 2–3 months
- review after treatment
Honest Google Reviews
From Recent Patients
Every review below is a genuine Google review from patients Dr Shaffer has been in the past, exactly as it was written. They are here so you can understand what a consultation and treatment are actually like from people who have experienced them.
4.9
★★★★★
300+ Google reviews
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Joe Sole 3 months ago
★★★★★
I had an initial consultation with Dr Shaffer today. The appointment was on time, very informative and reassuring. Dr Shaffer is clearly a leading expert and I would have no hesitation recommending him to my family and friends.
- Dupuytren's Patient
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Sarah Smith 11 months ago
★★★★★
Within 20 minutes of completing an online enquiry form Dr Shaffer had called me personally, discussed my condition and made an appointment to see him. He listened, gave me time to discuss every aspect and after a thorough examination gave me advice about whether I needed treatment at this time or not. I never felt under any pressure and completely trusted his expert opinion. At last somebody who took notice and understood the condition. I would highly recommend his care.
- Dupuytren's Patient
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Guy Strickland 9 months ago
★★★★★
I received radiotherapy treatment for Dupuytrens Contracture on my right hand which ended in March 2023. I’m happy to say that the progression of Dupuytrens has ceased in my right hand and no more nodules or contractures have appeared. Dr Shaffer and his team were very helpful and professional throughout and I would recommend their services gladly.
- Dupuytren's Patient
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Denise Mitchell a year ago
★★★★★
A lovely, friendly, efficient hospital. My appointment was on time. Dr Shaffer was welcoming and kind and thoroughly detailed his findings and the approach to my treatment. My schedule for the treatment was limited so every effort was made to accommodate me within my timeframe. The only surprise for me was the lack of parking at the hospital, so if you're taking your car it would be a good idea to research parking facilities within the area before your appointment.
- Dupuytren's Patient
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Simon Speirs 5 years ago
★★★★★
Despite the Covid-19 situation I was dealt with quickly and efficiently by all staff. Dr Shaffer was on-time and dealt with the examination of hands/feet. He was able to rely on records of a prior visit in 2011 to help with diagnosis (that I had lost). He was able to recommend treatment and courses of action - whether through him or colleagues. He was very helpful.
- Dupuytren's Patient
- Ledderhose Patient
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Beth Driver 10 months ago
★★★★★
I had treatment on my left hand a year ago by Dr Shaffer and his team. All good so far and the nodules do feel much softer. Unfortunately it has now started in my right hand but I'm hopeful the treatment will work as well on this hand. Dr Shaffer is really warm and personable. He really does help to put your mind at rest. His team are very friendly and kind too. Would highly recommend.
- Dupuytren's Patient
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Mark Patterson 6 months ago
★★★★★
Since receiving Radiotherapy treatment for Dupuytrens in my left hand, in 2022, there has been no noticeable growth in the cords and nodules present, and no signs of contraction. Dr Shaffer was swift to arrange my initial appointment and examination, and the therapy schedule was set up not long after. I am very happy with the whole experience from start to finish.
- Dupuytren's Patient
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Robert Fowler 6 months ago
★★★★★
Richard treated my Dupuytrens in 2021. At the time, I was developing a contracture. Treatment was easy and a complete success - no contractures and a fully functional hand.
- Dupuytren's Patient
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Barbara Hayes 11 months ago
★★★★★
My consultation with Dr Richard Shaffer was incredible. I have a severe case of Ledderhose disease and Dupuytrens. Dr Shaffer showed so much concern and interest in my case. For the first time in 51 years I am beginning to feel confident that someone may be able to assist me with this disease. It was an inspiration and a pleasure to meet with Dr Shaffer. Thank you so much.
- Ledderhose Patient
- Dupuytren's Patient
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Chris Bruce 11 months ago
★★★★★
Professional operation with an initial consultation with Richard Shaffer, who is very knowledgeable and experienced, followed by two sets of radiotherapy on both hands. My dupuytrens improved markedly so seeking help was worth the expense. Avoid pretenders and head to those that know what they're doing potentially saving yourself from surgery.
- Dupuytren's Patient
Where Dr Shaffer
Sees Patients
Dr Shaffer assesses patients in person at five locations nationwide. If travel is difficult, your first consultation can be held by video.
Treatment is available at 16 centres across the UK.
View Locations
Clear Answers From Your First Appointment
Your first appointment is about finding out whether radiotherapy has a place in your keloid care. By the end, you'll know where you stand and what the sensible next step is, whether or not that involves treatment with Dr Shaffer.
- A thorough look at your scar
- A clear explanation of why it has formed or returned
- An honest opinion on whether radiotherapy is worthwhile
- Advice on timing and on working alongside your surgeon
- Direct booking, with no GP referral needed
Radiotherapy and Keloids: Your Questions Answered
Does it hurt, and how many sessions will I need?
The radiotherapy itself is painless, and each session takes only a few minutes. Most people need between one and four sessions, depending on where the keloid is. Dr Shaffer will confirm the plan for your scar. The skin may feel sore for a few weeks afterwards, but this usually improves.
When is the radiotherapy given?
As soon as possible after the keloid is removed, because a healing wound is when a keloid is most likely to start growing again. UK guidance recommends starting ideally within 24 hours and no later than 72 hours, although research on the best timing is limited. This is why your operation and the radiotherapy are arranged together.
How safe is radiotherapy for keloids?
The doses used are low and target only the scar and the skin immediately around it. Short-term skin reactions are common but usually settle within weeks, and serious wound problems are uncommon in published studies. Radiation does carry a very small long-term risk of causing a cancer many years later. That's why treatment is for adults, is avoided in children and during pregnancy, and needs extra care near the thyroid and breast. Dr Shaffer will go through the balance of benefit and risk for your own scar.
Is there any guarantee the keloid will not return?
No treatment can make that promise. In pooled studies, around 1 in 5 keloids returned after surgery with radiotherapy, compared with roughly half or more after surgery alone. The chance also varies by site, with the ear faring best and the chest and upper trunk less well. A keloid that does return can sometimes be treated again. Dr Shaffer will explain what to expect for your own scar.
Can radiotherapy treat a keloid without surgery?
It can be considered when an operation is not possible or not wanted. However, the evidence is weaker than for radiotherapy after surgery and the results are less predictable. It tends to be reserved for particular situations, such as large or troublesome keloids in people who cannot have surgery. Dr Shaffer will give you a frank view, including when another approach would be more appropriate.
Can radiotherapy be used for a keloid on the ear?
Yes. Ear keloids often follow a piercing and are one of the sites where the evidence is most encouraging. In pooled studies, the ear had the lowest rate of regrowth, at around 1 in 8. A less intensive schedule is generally used for the earlobe.
Can I have this on the NHS, and do I need a GP referral?
Some NHS hospitals offer radiotherapy after keloid surgery, usually arranged through a dermatology or plastic surgery team, though availability varies by area. Appointments with Dr Shaffer are private, and you don't need a GP referral. You can book online or send an enquiry, and the team will be in touch to discuss the next steps.
