 [ Symptoms ] my wife is considering surgery for itchy painful keloid scars after shots did not help is that the best option [ Disease ] probably the most important thing to do is to not wear your hair in a tight ponytail or elastic band while you sleep the tension on the hair may result in hair breakage during the night also if you have a tendency to pull or twirl your hair while you sleep which you may not be aware of you may benefit from wearing a silk or cotton bonnet or cap similar to a shower cap just be sure the elastic is not too tight around your forehead and hairline