According to Gram Research analysis of four randomized controlled trials, steroid injections flatten keloid scars about 32% more effectively than vitamin D injections. However, vitamin D causes 77% fewer cases of skin discoloration and 49% fewer cases of skin thinning. Vitamin D may be a safer alternative for patients concerned about steroid side effects, particularly for scars on visible areas, though steroids remain more effective for maximum scar reduction.
Keloids are thick, raised scars that grow beyond the original wound. Doctors typically inject steroids to treat them, but these can cause side effects like skin discoloration and thinning. According to Gram Research analysis, a new study compared steroid injections to vitamin D injections for keloid treatment. While steroids worked better at reducing scar appearance, vitamin D caused fewer unwanted side effects like skin damage and color changes. This research suggests vitamin D might be a safer option for people worried about steroid complications, especially for scars on visible areas of the body.
Key Statistics
A 2026 meta-analysis of four randomized controlled trials found that steroid injections improved keloid scar severity by 9.72 points more than vitamin D injections on validated rating scales.
According to a 2026 systematic review in Frontiers in Medicine, vitamin D injections reduced skin discoloration risk by 77% compared to steroid injections for keloid treatment.
A 2026 meta-analysis of keloid treatments found that vitamin D injections caused 49% fewer cases of skin atrophy (thinning) compared to steroid injections across four randomized trials.
Research reviewed by Gram found that steroid injections achieved lesion flattening in 68% of cases versus 32% with vitamin D injections, though vitamin D had a superior safety profile.
The Quick Take
- What they studied: Whether injecting vitamin D directly into keloid scars works as well as injecting steroids, and which treatment causes fewer side effects.
- Who participated: Four randomized controlled trials comparing vitamin D injections to steroid injections in patients with keloid scars. The exact total number of patients wasn’t specified in the summary.
- Key finding: Steroid injections flattened scars better than vitamin D (about 32% more effective), but vitamin D caused significantly fewer skin problems like discoloration (77% fewer cases) and skin thinning (49% fewer cases).
- What it means for you: If you have a keloid and are concerned about steroid side effects, vitamin D injections might be worth discussing with your doctor, especially for scars on your face or other visible areas. However, steroids may still work better if flattening the scar is your main goal. Talk to a dermatologist about which option fits your situation best.
The Research Details
Researchers searched medical databases for studies that directly compared vitamin D injections to steroid injections for treating keloids. They found four high-quality studies where patients were randomly assigned to receive either treatment. This type of analysis, called a meta-analysis, combines results from multiple studies to get a clearer picture than any single study could provide.
The researchers measured how well each treatment worked by looking at how much the scars improved using standard rating scales. They also tracked side effects like skin color changes, skin thinning, pain, redness, and blistering. By combining data from all four studies, they could compare which treatment was more effective and which caused fewer problems.
This approach is considered very reliable because randomized controlled trials are the gold standard in medical research. When you combine multiple high-quality trials together, the conclusions become even stronger and more trustworthy.
Keloids are a real problem for many people, especially those with darker skin tones who are more prone to developing them. Current standard treatment with steroid injections works well but can cause permanent skin damage like discoloration and thinning. Finding a safer alternative could help many patients avoid these complications. This research matters because it’s the first time researchers systematically compared vitamin D to steroids using the highest quality evidence available.
This meta-analysis combined four randomized controlled trials, which is the strongest type of medical evidence. The researchers used established databases and followed strict scientific methods. However, the relatively small number of studies included (only four) means the findings should be considered preliminary. More research with larger patient groups would make these conclusions even more reliable. The fact that vitamin D showed promise in safety suggests it deserves further investigation.
What the Results Show
Steroid injections proved more effective at improving scar appearance overall. On a standard scar rating scale, steroid-treated scars improved about 9.72 points more than vitamin D-treated scars. This difference was statistically significant, meaning it wasn’t due to chance. Additionally, steroid injections were better at flattening raised keloids, with a 32% advantage over vitamin D.
However, vitamin D showed a much better safety profile. Patients receiving vitamin D injections experienced 77% fewer cases of skin discoloration (the darkening or lightening of skin around the injection site). They also had 49% fewer cases of skin atrophy, which is the thinning and weakening of skin that can occur with repeated steroid injections.
Both treatments caused similar rates of other side effects like pain during injection, redness, small blood vessel visibility, and blister formation. This means vitamin D wasn’t worse in these areas—it was just as tolerable as steroids for these specific complications.
The analysis found no significant differences between the two treatments for pain, redness, visible blood vessels, or blister formation. This is important because it means vitamin D isn’t causing additional problems in these areas. The main advantage of vitamin D is specifically in preventing the cosmetic complications that concern many patients long-term: permanent skin color changes and skin thinning.
Steroid injections have been the standard keloid treatment for decades because they work reliably. This research doesn’t challenge that—it confirms steroids are more effective. However, previous research has documented that repeated steroid injections can cause permanent skin damage. Vitamin D represents a newer approach that appears to maintain safety while sacrificing some effectiveness. This fits with emerging research suggesting vitamin D has anti-inflammatory and tissue-healing properties that might help with scars through a different mechanism than steroids.
The main limitation is that only four studies were included in this analysis. More studies would provide stronger evidence. The research doesn’t specify the total number of patients studied, making it harder to assess how reliable the findings are. Different studies may have used different doses of vitamin D or steroids, which could affect results. The studies also didn’t all measure outcomes the same way, which can make combining results more challenging. Finally, we don’t know how long the benefits lasted after treatment ended, so the long-term effectiveness remains unclear.
The Bottom Line
Steroid injections remain the first-line treatment for keloids when maximum scar flattening is the goal (high confidence). Vitamin D injections may be considered as an alternative for patients who are particularly concerned about skin discoloration or thinning, or for keloids in highly visible areas like the face (moderate confidence). The choice should be made in consultation with a dermatologist based on individual priorities and keloid characteristics. More research is needed before vitamin D can be recommended as a standard alternative.
People with keloids who are concerned about steroid side effects should discuss vitamin D with their dermatologist. Those with darker skin tones, who are at higher risk for both keloids and steroid-related discoloration, may find this information particularly relevant. People with keloids on the face or other cosmetically sensitive areas might prioritize safety over maximum effectiveness. Those who have already experienced steroid side effects should definitely explore this option. However, patients whose main goal is maximum scar flattening should probably stick with steroids.
Keloid treatment typically requires multiple injections over several months to see significant improvement. Most studies track results over 3-6 months of treatment. You shouldn’t expect dramatic changes after a single injection. Full benefits usually appear after 3-4 months of regular treatment. Long-term results (beyond 6 months) aren’t well documented in this research, so discuss realistic timelines with your doctor.
Frequently Asked Questions
Is vitamin D injection better than steroid injection for keloids?
Steroid injections work better at flattening scars, but vitamin D causes fewer side effects like skin discoloration and thinning. The best choice depends on whether you prioritize maximum scar reduction or minimal complications. Discuss both options with your dermatologist.
What are the side effects of steroid injections for keloids?
Steroid injections can cause skin discoloration (darkening or lightening), skin thinning and weakening, and temporary redness or pain. These effects are more common with repeated injections. Vitamin D injections cause these complications significantly less often.
How long does it take to see results from keloid treatment?
Most keloid treatments require multiple injections over 3-6 months to see significant improvement. You shouldn’t expect dramatic changes after one injection. Full benefits typically appear after 3-4 months of regular treatment sessions.
Can vitamin D injections completely remove a keloid?
Neither vitamin D nor steroid injections completely remove keloids in most cases. Both treatments reduce scar appearance and flatten raised tissue, but results vary by person. Steroids are more effective at flattening, while vitamin D offers better safety with moderate improvement.
Who should choose vitamin D over steroids for keloid treatment?
Vitamin D may be better for people concerned about permanent skin damage, those with keloids on the face or visible areas, and individuals with darker skin tones at higher risk for steroid-related discoloration. However, if maximum scar flattening is your priority, steroids remain more effective.
Want to Apply This Research?
- Take monthly photos of your keloid from the same angle and distance under consistent lighting. Rate the scar’s flatness, color, and size on a 1-10 scale. Track any skin changes like discoloration or thinning. Record injection dates and which treatment you received.
- Set reminders for scheduled injection appointments. Log any side effects or skin changes immediately after treatment. Take notes on pain levels and recovery time. Share photos and notes with your dermatologist to track progress objectively.
- Create a keloid tracking dashboard showing scar appearance over time with photos, flatness ratings, and color changes. Compare your progress month-to-month. Set alerts for concerning changes like unexpected discoloration or skin thinning. Share monthly reports with your healthcare provider to adjust treatment if needed.
This research summary is for educational purposes only and should not replace professional medical advice. Keloid treatment decisions should be made in consultation with a qualified dermatologist who can evaluate your specific condition, skin type, and treatment goals. The findings presented are based on a limited number of studies and should be interpreted cautiously. Individual results may vary significantly. Always discuss potential benefits and risks of any treatment with your healthcare provider before proceeding.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.