Caesarean section scars, surgical incisions, burn scars – these raised, red, itchy bumps are not only unsightly but often accompanied by persistent itching and pain that make daily life uncomfortable. The scar injection (medically known as “intralesional drug injection therapy”) is a non‑surgical, minimally invasive treatment for such pathological scars. It works by injecting medication directly into the raised scar tissue, fundamentally inhibiting excessive scar growth and promoting softening and absorption. But is the scar injection suitable for all types of scars? Can a single session flatten a scar? Are there side effects? This article will comprehensively walk you through the principles, suitable candidates, treatment options and prices, procedure experience, duration of results, and potential risks – giving you all the key information in one place so you can make a rational choice.
The scar injection is not a specific injectable product, but rather a treatment method that delivers medication precisely into raised scar tissue. Its core function is to inhibit abnormal scar proliferation from within and promote softening and absorption. The most commonly used and proven medications in clinical practice are primarily corticosteroids, often combined with other drugs.
The mechanism of the scar injection can be understood on three levels: Inhibiting proliferation – the medication suppresses the over‑proliferation of fibroblasts, reducing abnormal collagen deposition, essentially “calling a halt” to the scar’s continuous growth at its source; Promoting degradation – the medication enhances collagenase activity, accelerating the breakdown and remodelling of existing collagen fibres in the scar tissue, allowing the raised scar to gradually flatten and soften; Relieving symptoms – rapidly alleviating itching, pain, and other discomforts associated with the scar.
In simple terms, the scar injection is like applying the brakes to overactive scar tissue – stopping it from growing further while helping the existing raised portion gradually soften and subside. It’s important to note, however, that no current technology can completely eliminate a scar. The goal of treatment is to make the scar’s appearance closer to that of normal skin, so it becomes less noticeable.
Scar injections primarily target pathological scars that are raised above the skin surface and still in the proliferative phase. Specifically, they are suitable for the following groups:
However, not everyone is suitable. Absolute contraindications or conditions requiring careful evaluation include: scars in the acute infectious phase or with open wounds; pregnancy and breastfeeding; severe hypertension, diabetes, or history of cardiovascular or cerebrovascular disease; liver or kidney insufficiency; malignant tumours; scars that have already matured or are depressed (injection may have limited effect or even worsen the depression).
Scar injection drug formulations and costs vary depending on scar size, type, and treatment plan. The main drug options are as follows:
Below is a comparison of these options with reference prices (in KRW):
| Option | Best for | Features | Reference price (KRW/session) |
|---|---|---|---|
| Standard steroid injection (single) | Mild‑to‑moderate hypertrophic scars | Most classic option, fast‑acting, cost‑effective | ~80,000 – 250,000 |
| Enhanced combination injection (steroid + 5‑FU) | Moderate‑to‑severe keloids, recurrent scars | Synergistic effect, lowers recurrence rate | ~150,000 – 300,000 |
| Injection + laser combination | Stubborn, thick keloid scars | Comprehensive treatment, more durable results | ~250,000 – 500,000 |
Note: Prices above are reference ranges for the Korean market. Actual pricing varies by scar size, drug formulation, and clinic qualification – please refer to your in‑person consultation. A course typically consists of 3‑6 sessions at 3‑5 week intervals.
Your choice should be made after discussing scar type, size, location, and previous treatment history with a specialist. Generally, steroid monotherapy is suitable for mild cases, while moderate‑to‑severe or recurrent keloids require combined injections or multi‑modality therapy.
Pre‑procedure preparation: On your first visit, the doctor assesses scar type, thickness, and blood supply through visual inspection and palpation, then designs a personalised treatment plan. The doctor will also ask about your health status, medication history, and allergies to confirm suitability for injection.
During the procedure: The doctor uses a fine needle to inject the medication at multiple points into the dermal layer of the scar. Precise injection within the scar boundary is critical – if the medication spreads beyond the scar, it may cause atrophy of surrounding normal tissue. A single session takes about 10‑20 minutes. Pain can be more noticeable when the scar is very hard; local anaesthetic is typically used.
Immediately after: Apply pressure until bleeding stops. Localised redness, swelling, and pain may occur, which can be relieved with ice packs. Avoid water contact for 6 hours after treatment.
The effects of scar injections unfold in three phases: Initial improvement (2‑4 weeks post‑injection) – scar hardness decreases, colour lightens, and itching subsides. Results can typically be evaluated at 1 month – if the hypertrophic scar has flattened, softened, lightened, and itching has improved, the treatment is considered effective.
Progressive improvement (3‑6 months) – with cumulative effects from multiple sessions, the scar further flattens, softens, and redness fades. Clinical data shows that approximately 70%‑80% of patients achieve significant softening after standard treatment; about 80%‑90% of keloid patients experience a >50% reduction in scar thickness after standard injection protocols.
Stabilised effect (6‑12 months) – the scar enters a relatively stable phase, with sustained improvement in appearance and symptoms. Injection results can be maintained long‑term, but the recurrence rate for keloids is as high as 30%‑50%, requiring long‑term follow‑up and management.
A standard course consists of 3‑6 sessions at 3‑5 week intervals. It’s important to emphasise: never stop treatment on your own – some patients stop when the scar appears flattened, but if the scar is still in its proliferative phase and the medication effect wears off, rebound can occur, sometimes even worse than before.
Q: Is the scar injection painful?
A: Pain can be more noticeable when the scar is very hard. However, doctors typically use local anaesthetic, and as the scar gradually softens with treatment, pain during subsequent sessions decreases significantly. Each session takes about 10‑20 minutes, and most people tolerate it well.
Q: Are there side effects or long‑term risks?
A: Yes, but most are manageable. Common side effects include:Skin atrophy and depression– this is the most concerning side effect. If the medication spreads to normal tissue, it can cause tissue atrophy. Therefore, precise injection within the scar boundary is critical, requiring significant skill and experience from the doctor;Localised hyperpigmentation or hypopigmentation– the treated area may become darker or lighter;Telangiectasia– appearance of fine red blood vessels;Menstrual irregularities– a small number of female patients may experience menstrual changes, which typically resolve after stopping or extending treatment intervals;Local infection– due to improper injection technique. Systemic side effects are very rare with single low‑dose injections, but long‑term, high‑frequency use is not recommended.
Q: Will the scar recur after injections? Will it get bigger?
A: Recurrence is possible, especially with keloids. Keloids are inherently in a long‑term, recurring proliferative state – injection or surgery alone often leads to relapse. If left untreated after recurrence, the condition will continue to worsen – it does not mean the injections “made it bigger.” To avoid recurrence, the key is tocomplete the full course of treatment(typically 3‑6 sessions), gradually reduce concentration and extend intervals, and finally discontinue medication smoothly. If steroids alone are insufficient, combining with 5‑FU injections can effectively reduce recurrence rates.
Q: Can scar injections be used for atrophic or mature scars?
A: Not recommended. Scar injections primarily targetpathological scars that are raised and still in the proliferative phase. For mature, stable scars (greyish‑white, soft, no congestion), the medication is unlikely to be effective; for atrophic scars, steroid injections may exacerbate tissue atrophy. These types of scars are better suited for laser or surgical repair.
Q: How much does a scar injection cost in Korea?
A: In Korea, standard steroid injections range from80,000‑250,000 KRWper session; enhanced combination injections (steroid + other drugs) range from150,000‑300,000 KRW; injection + laser combination ranges from250,000‑500,000 KRW. A typical course requires3‑6 sessions. Prices vary by scar size, drug formulation, and clinic – please refer to your in‑person consultation.
⚠️ Important reminder: Scar injections are effective, but they are not a “one‑injection magic flattening” treatment. Below are the core risks and precautions you must understand:
Core risks: Skin atrophy and depression are the most concerning side effects. The medication must be precisely injected within the scar boundary – if it spreads beyond, normal tissue will also atrophy, making later repair very difficult. Other risks include pigment changes, telangiectasia, and menstrual irregularities. Systemic side effects are rare with low‑dose injections, but long‑term, high‑frequency use is not recommended.
Post‑care essentials: Apply pressure until bleeding stops after injection; avoid water contact for 6 hours; strict sun protection to prevent pigmentation; darkening or whitening of the treated area early on is normal and usually resolves on its own; never stop treatment on your own – complete the full course; otherwise, rebound is likely.
To minimise risks, be sure to: choose a licensed medical institution and an experienced doctor – injection precision directly determines safety and outcomes; fully disclose your health status – including hypertension, diabetes, pregnancy, allergies, etc.; be realistic about results – repairing a scar is like mending a torn garment – some trace will always remain. Find a specialist, choose the right treatment for you, and be prepared for long‑term cooperation. Early intervention and standardised treatment are the keys to overcoming scars!
Medical disclaimer:
This article is for educational and informational purposes only and does not constitute medical advice, diagnosis, or treatment recommendations. Aesthetic procedures involve individual variations – results and risks differ from person to person. Prices, formulations, and other information mentioned are for reference only – please refer to actual consultations for current details.
All medical procedures carry potential risks (including but not limited to infection, allergy, skin atrophy, pigmentation changes, unsatisfactory results, etc.). Before making any decision, please consult a qualified medical professional in person, who can assess your suitability based on your health status, constitution, and needs. The author and publisher assume no legal liability for any decisions made based on this content.
If you experience any discomfort or have concerns, please seek prompt advice from a licensed physician.