The treatment of keloids is a frustrating problem for both patient and surgeon. Dr Hom presents an excellent review of the treatment options for keloids. In my practice, earlobe keloids are certainly the most common type of keloid treated. I agree with Hom that the manner in which the keloid is excised has little to do with its risk of recurrence. Recurrence is mostly related to the compliance of the patient with a postoperative regime of intralesional steroid injections, pressure earrings, and/or silicone gel applications. Patients who are compliant with one or more of these follow-up treatments have acceptably low rates of recurrence.
Driscoll B. Treating Keloids With Carbon Dioxide Lasers. Arch Otolaryngol Head Neck Surg. 2001;127(9):1145. doi:10.1001/archotol.127.9.1145