Keloids
蟹足肿 · xiè zú zhǒng+2 other namesHide other names
Also known as: Keloid Scar, Keloid Scars
A red, itchy, oozing keloid and a dark, hard, stabbing one are not the same problem - TCM treats them differently, and many patients see softening and relief within weeks once the right internal pattern is addressed.
About this page · what it is and isn't
What this is. A plain-English synthesis of how classical TCM and modern clinical research describe keloids. Patterns and herbs come from canonical TCM sources; clinical claims are cited in the Evidence section.
What it isn't. A diagnosis. Me&Qi is an editorial team, not a licensed clinic. The pattern quiz is a thinking tool — pulse and tongue still need a person in the room. Anything in the Safety section should send you to a doctor, not a herb.
Last reviewed Jun 2026.
Educational content about Traditional Chinese Medicine — not medical advice. See a qualified practitioner for diagnosis and treatment.
Keloids aren't just overgrown scars in Traditional Chinese Medicine - they're a visible sign that something inside the body is out of balance. Where conventional medicine sees a localized skin problem, TCM identifies five distinct internal patterns that can drive the scar to spread, itch, and thicken. These patterns range from Damp-Heat brewing in the Blood to deep Blood Stagnation, and each one requires a different treatment strategy.
The good news is that by addressing the root imbalance - not just the scar - TCM aims to soften keloids, relieve discomfort, and reduce the likelihood of new ones forming. The patterns you'll explore below reflect how a practitioner would diagnose you, looking at the scar's color, temperature, and your whole-body signs.
Keloids are benign fibrous growths that form when the body overproduces collagen during wound healing. They extend beyond the boundaries of the original injury - whether from surgery, piercing, acne, or a minor cut - and don't regress on their own. Keloids can be itchy, painful, tender, and cosmetically distressing, and they tend to run in families, especially among people with darker skin tones.
Diagnosis is usually made by a doctor simply looking at the scar and hearing the history. Because keloids are not cancerous, no biopsy is needed unless the diagnosis is uncertain.
Conventional treatments
Conventional treatments aim to flatten the scar and relieve symptoms. First-line options include corticosteroid injections directly into the keloid to reduce inflammation and slow collagen production. Other approaches include silicone sheets or gels, pressure therapy, cryotherapy (freezing), laser treatments, and surgical excision, though surgery alone carries a high risk of the keloid returning even larger. Often, multiple methods are combined to improve results.
Where conventional treatment falls short
While corticosteroids and other procedures can shrink a keloid temporarily, they don’t address the internal tendency to form these aggressive scars. Recurrence after treatment - especially after surgery - is common, and repeated steroid injections can thin the skin or cause discoloration.
The conventional model treats all keloids as the same problem, but TCM recognizes that a hot, red, oozing keloid and a dark, hard, stabbing one arise from very different internal landscapes. By correcting that underlying imbalance, TCM offers a more personalized and potentially longer-lasting solution.
How TCM understands keloids
In TCM, a keloid is seen as a local manifestation of a deeper disharmony - most often involving the Blood, the Spleen, and the Liver. When the body is healthy, a wound heals cleanly and leaves a flat, pale scar. But if internal Heat, Dampness, or Blood Stagnation is already present, the healing process goes awry, and the scar tissue overgrows like a crab's claw, which is exactly what the Chinese name 蟹足肿 (xiè zú zhǒng) means.
The Spleen is central to managing fluids. A diet heavy in greasy, sweet, or spicy foods can weaken the Spleen and generate Dampness, which then mixes with Heat and gets trapped in the Blood. After a skin injury, this Damp-Heat rushes to the wound, making it red, swollen, and intensely itchy. This is one of the most common patterns, especially in people who feel heavy, sluggish, and have a greasy tongue coating.
The Liver, which governs the smooth flow of Qi and Blood, also plays a key role. Emotional stress, frustration, or a constitution prone to stagnation can cause Qi to get stuck. When Qi stagnates, Blood can't move properly, and a hard, dark purple keloid forms with a fixed, stabbing pain that's worse at night - a classic Blood Stagnation pattern.
In other cases, an excess of internal Heat alone can blaze up at the wound site, creating an angry red, hot, painful lesion without much Dampness.
Less commonly, the body may be too weak to heal properly. When Qi and Blood are deficient, the repair process is sluggish and disorganized, leading to pale, hardened keloids that form slowly and resist treatment. And if a wound becomes infected with Toxic-Heat, the keloid can suppurate, ooze, and throb. Recognizing which of these five patterns is driving the scar is the key to choosing the right herbs, acupuncture points, and dietary changes.
「肉蜈蚣，形如蜈蚣，长数寸，生于皮里膜外，由湿热毒邪流注而成。」
"The 'flesh centipede' is shaped like a centipede, several inches long, growing between the skin and the membrane. It is caused by Damp-Heat Toxin pouring down and accumulating."
How a TCM practitioner diagnoses keloids
Inside the consultation
A practitioner begins by inspecting the keloid itself - its colour, temperature, and whether it weeps or itches. A bright red, hot, and swollen lesion that feels painful to touch and has a greasy yellow tongue coating points strongly toward Damp-Heat brewing in the Blood. The pulse is often slippery and rapid, and the person may also complain of a heavy body or loose stools.
When the keloid is intensely red, hot, and painful, but the tongue is red with little or no coating and the pulse feels large and flooding, the picture shifts to Excess-Heat blazing locally. This pattern often flares up suddenly after an injury or surgery, and the heat sensation can be quite severe.
A dark red-purple, hardened nodule with stabbing or fixed pain suggests Blood Stagnation. Here the tongue looks dusky or has purple spots, and the pulse feels wiry or choppy. The colour and quality of the scar are the main clues - the lesion is less about active heat and more about old, congealed blood that refuses to move.
If the keloid begins to ooze pus, exudate, or breaks down, Toxic-Heat is taking hold. The tongue coating becomes thick and yellow, the pulse turns slippery and rapid, and the pain intensifies. This signals deeper tissue damage and a shift from a solid mass to an active infection-like process that needs urgent attention.
In a person who looks pale, tires easily, and whose keloid forms slowly without much redness or heat, underlying Qi and Blood Deficiency is often the root. The tongue is pale with a thin coat and the pulse is weak. The body simply lacks the resources to heal cleanly, so scars overgrow in a disorganised way.
TCM Patterns for Keloids
In TCM, the aim is to address the root cause, not just the symptom — it calls that root cause a “pattern.” The same keloids can come from several different patterns, each treated differently. The quickest way to find yours is the quiz below.
Find your pattern
Tap any sign that fits how yours feels.
- 1Your signs
- 2What makes it worse
- 3What helps
Which signs match your experience?
It is very common to see yourself in more than one pattern. A keloid may start as Damp-Heat, then turn darker and harder as Blood Stagnation sets in, or become infected and move toward Toxic-Heat. These patterns are snapshots of a process, not rigid boxes, so overlapping signs are expected.
To get clearer, pay attention to the dominant feature. Is the scar angry red and weeping, or is it a dull purple lump that aches? A hot, oozing lesion leans toward Damp-Heat or Toxic-Heat, while a dark, dry, stabbing scar points to Blood Stagnation. If you feel generally run down and the scar is pale and slow to change, Deficiency is likely in the mix.
Because tongue and pulse examination are essential to distinguish these patterns - especially the subtle difference between Damp-Heat and Toxic-Heat, or between Excess-Heat and Blood Stagnation - a professional TCM diagnosis is strongly recommended. Self-treatment based on pattern alone can miss the deeper imbalance.
If the keloid suddenly becomes very painful, hot, or starts discharging pus, see a practitioner promptly. That shift toward Toxic-Heat may need stronger intervention. A trained eye can also spot when a pattern is purely local or when it reflects a whole-body disharmony that needs long-term rebalancing.
Damp-Heat
Blood Stagnation
Excess-Heat
Toxic-Heat
Qi and Blood Deficiency
Treatment
Four ways to address keloids in TCM — explore each, or take the quiz to see what fits you first.
Formulas traditionally used for keloids
4 formulas across the patterns above. The right one depends on your pattern — start with the quiz if you're unsure which fits.
A powerful cooling formula used to address conditions caused by excess heat and dampness in the Liver and Gallbladder systems. It is commonly used for red, painful eyes, headaches, ear problems, irritability, urinary difficulties, and skin conditions like shingles, particularly when accompanied by a bitter taste in the mouth, dark urine, and a feeling of heat or inflammation along the sides of the body or in the genital area.
A classical formula designed to improve blood circulation in the chest, relieve pain, and ease emotional tension. It is widely used for chronic chest pain, stubborn headaches, insomnia, and irritability caused by poor blood flow and stagnation in the upper body.
A renowned classical formula used to treat red, hot, swollen, and painful skin infections such as boils, abscesses, and inflamed sores in their early stages. It works by clearing the internal Heat driving the infection, improving local blood circulation to reduce swelling and pain, and helping the body expel pus and toxins. Historically called "the foremost formula in external medicine" and "the sacred remedy for abscesses," it is also applied in modern practice for conditions such as mastitis, inflammatory acne, tonsillitis, and appendicitis.
A powerful classical formula that clears intense heat and toxins from all levels of the body. It is used for conditions involving high fever, restlessness, infections, skin eruptions, and bleeding caused by excessive internal heat. Because it is strongly cooling, it is intended only for acute, excess-heat conditions and not for long-term use.
Excess patterns like Damp-Heat and Excess-Heat often respond within the first 4-8 weeks, with itching and redness calming down noticeably. Blood Stagnation keloids, which are older and harder, may take 3-6 months to soften significantly. Qi and Blood Deficiency patterns are the slowest, sometimes requiring 6 months or more to rebuild the body's reserves. External applications and acupuncture can accelerate visible changes.
Treatment principles
Across all patterns, the core of TCM treatment is to clear the internal pathogenic factors that are driving the keloid - whether that's Damp-Heat, Excess-Heat, Toxin, or Blood Stagnation - and to restore the smooth flow of Qi and Blood so the skin can heal properly. In deficiency patterns, the priority shifts to strengthening Qi and Blood so the body has the resources to remodel the scar.
Treatment almost always combines internal herbal formulas with external applications. Herbs taken by mouth correct the underlying imbalance, while ointments, pastes, or acupuncture work locally to soften the tissue and relieve itching. The exact formula and points chosen depend entirely on the pattern: for Damp-Heat, we drain and cool; for Blood Stagnation, we invigorate and move; for Toxic-Heat, we detoxify and drain pus. This dual inside-outside approach is what makes TCM so effective for stubborn keloids.
What to expect from treatment
Your practitioner will likely recommend weekly acupuncture sessions and a daily herbal formula, along with dietary changes. External herbal applications may be used a few times a week. In the first month, you can expect a noticeable decrease in itching, pain, and redness. Over the next 2-6 months, the keloid should begin to soften and flatten, though the pace varies by pattern.
Consistency is key. Missing doses or sessions can slow progress. Because keloids are a chronic tendency, your practitioner may also suggest maintenance treatments - perhaps seasonal acupuncture or a short course of herbs - to prevent new keloids from forming after any future skin injuries.
General dietary guidance
Regardless of your pattern, a diet that avoids generating Dampness and Heat is the best baseline for keloid-prone skin. Favor cooling, light foods like mung bean soup, cucumber, celery, and bitter leafy greens. Lean proteins and whole grains are fine, but steer clear of deep-fried foods, excessive red meat, alcohol, and sugary treats. For deficiency patterns, add nourishing, easy-to-digest foods like bone broth, congee, and cooked root vegetables to support Qi and Blood without overwhelming the Spleen.
Combining TCM with conventional treatment
TCM and conventional treatments can often be combined safely and effectively. If you are receiving corticosteroid injections, you can usually continue them while starting herbs and acupuncture; just make sure both practitioners know what the other is doing. If you are considering surgical removal, it's wise to begin TCM before and after the procedure to reduce the risk of recurrence, as surgery can trigger a larger keloid in susceptible individuals.
There are no well-documented dangerous interactions between common keloid herbs and conventional medications, but herbs that strongly move Blood (like Tao Ren or Hong Hua) should be used cautiously if you're on blood thinners. Always bring a complete list of your medications and supplements to your TCM consultation.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Safety & special considerations
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Rapid growth of the keloid over days or weeks — Could indicate a more aggressive process or, rarely, a malignant change.
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Signs of infection: increasing pain, pus, foul odor, or fever — May require antibiotics or drainage; do not rely on herbs alone.
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Ulceration or open sore developing on the keloid — Needs medical evaluation to rule out skin cancer or severe infection.
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Bleeding that doesn't stop with gentle pressure — Could be a sign of a deeper vascular problem or trauma.
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Severe, unrelenting pain not relieved by usual measures — May indicate nerve involvement or infection that needs urgent attention.
Audience-specific guidance — open what applies to you
During pregnancy, many blood-moving herbs commonly used for keloids - such as Tao Ren, Hong Hua, and Chuan Xiong - are strictly contraindicated because they can stimulate uterine contractions and risk miscarriage. Bitter-cold formulas like Long Dan Xie Gan Tang are also avoided as their cold nature can harm the developing fetus.
Acupuncture is a safer option, but points on the lower abdomen and lumbosacral area must be avoided. Gentle Qi and Blood tonification with herbs like Dang Gui (in small doses) and Huang Qi may be used if a deficiency pattern is present. External herbal applications are often preferred to minimize systemic exposure.
Bitter-cold herbs such as Huang Lian and Zhi Zi can pass into breast milk and cause diarrhea in the nursing infant, so they are best avoided. For Damp-Heat patterns, milder herbs like Fu Ling and Yi Yi Ren are safer alternatives that still clear Dampness without the harsh cold.
Blood-moving herbs should be used cautiously as they may affect milk supply. Acupuncture remains a safe and effective treatment during breastfeeding, and local needling around the keloid can help soften the scar without systemic side effects for the baby.
Keloids in children often follow burns, surgery, or severe acne. The most common patterns are Damp-Heat and Excess-Heat, as children’s Spleen is still developing and easily generates Dampness. Pediatric dosages of herbal formulas should be reduced to one-third to one-half of the adult dose, and strong blood-moving herbs are generally avoided unless absolutely necessary.
Children may not tolerate deep acupuncture, so shallow needling and gentle techniques are used. External poultices with herbs like Jin Yin Hua and Lian Qiao can be very effective. Always protect the child’s digestion by adding spleen-strengthening herbs like Bai Zhu to any formula.
In elderly patients, keloids are more likely to arise from a Qi and Blood Deficiency pattern. The scar may be pale, less inflamed, but slow to heal. Treatment focuses on tonifying the Spleen and Stomach to generate Qi and Blood, using points like Zusanli ST-36 and Sanyinjiao SP-6, and herbs such as Dang Gui and Huang Qi.
Herbal dosages should be lower - typically two-thirds of the adult dose - and careful attention must be paid to drug interactions with common medications. Acupuncture is often better tolerated than herbs. Treatment timelines are longer, as the elderly body rebuilds more slowly.
Evidence & references
Research on TCM for keloids is limited but encouraging. Small Chinese clinical studies suggest that herbal formulas such as Xue Fu Zhu Yu Tang and Long Dan Xie Gan Tang can reduce keloid size, itching, and pain when used alone or alongside conventional treatments like corticosteroid injections. Acupuncture and moxibustion have also been reported to soften scar tissue and improve local circulation.
However, most studies are uncontrolled, have small sample sizes, and are published only in Chinese, which limits their generalizability. Anecdotal success with proprietary formulations like the Xiao Ji Pai Tong San patent exists, but rigorous randomized controlled trials are still needed to confirm efficacy and safety.
Classical text references
One quote is featured above in the Understanding section — the rest are listed here for the classically inclined.
「蟹足肿者，因伤后气血凝滞，湿热搏结，致肉芽突起，形如蟹足。」
"Keloid (crab's foot swelling) occurs after injury when Qi and Blood congeal and Damp-Heat binds together, causing a fleshy protrusion shaped like a crab's foot."
《外科正宗》 (Orthodox Manual of External Medicine)
Chapter on Scars and Masses
Frequently asked questions
Common questions about using Traditional Chinese Medicine for keloids.
Yes, but older keloids tend to respond more slowly. Acupuncture works by improving local circulation and breaking up stagnation, so even long-standing hard scars can soften over time. The needles are usually placed around the keloid - not directly into the thickest part - to encourage healing without triggering more growth. You'll likely need a longer course of treatment, often combined with herbs, for the best results.
TCM aims to reduce the underlying tendency to form keloids, so the risk of recurrence is lower than with treatments that only address the scar itself. However, no method can guarantee that a keloid won't return, especially if you have a strong genetic predisposition. By continuing to follow dietary and lifestyle advice after the scar has flattened, you give yourself the best chance of staying keloid-free.
Yes, TCM can often be safely combined with conventional treatments. Many patients use herbs and acupuncture while continuing with silicone sheets or occasional steroid injections. Always tell both your TCM practitioner and your dermatologist about all treatments you're using so they can coordinate care. There are no known serious interactions between corticosteroid injections and the herbs commonly prescribed for keloids, but full disclosure is essential.
In general, it's wise to avoid foods that create Dampness and Heat in the body - these include greasy, fried, and very spicy dishes, as well as excessive sugar and alcohol. Dairy and rich, sweet foods can also contribute to Dampness. Your TCM practitioner can give you more specific guidance based on your pattern, but starting with a cleaner, lighter diet often helps reduce itching and redness.
Many external treatments like gentle acupuncture and some herbal ointments can be used during pregnancy, but internal herbal formulas must be carefully selected by a qualified practitioner. Some herbs that move Blood or clear Heat are contraindicated in pregnancy. If you are pregnant or breastfeeding, always inform your TCM practitioner so they can adjust your treatment plan accordingly.
Itching and pain are often the first symptoms to respond to TCM. With herbs and acupuncture, many patients notice a significant reduction in discomfort within 2-3 weeks, even if the scar itself still looks the same. This early relief can be a sign that the internal imbalance is starting to correct, and the scar will gradually soften over the following months.
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