Background <p>Keloid scars can be challenging to manage, especially in resource-limited settings. This case demonstrates successful regression of a chronic keloid with a single intralesional corticosteroid injection.</p> Case presentation <p>A 29-year-old Iranian male with a 3-year history of a posttraumatic keloid on the posterior elbow presented after failing to respond to topical therapies. A single dose of triamcinolone–lidocaine (1:1 ratio) was injected intralesionally. A total of 4 weeks postinjection, significant flattening and softening of the keloid was observed, and the patient returned 3 months later with sustained improvement.</p> Conclusion <p>This case highlights the potential efficacy of a single intralesional corticosteroid injection for chronic keloid management in primary care.</p>