Should I excise my keloid? I have a big lump of scar tissue under the skin

Injection treatments can be very effective to soften bulky scar tissue or keloids. In many cases, excision is also required to eliminate the bulk of the scar tissue. However, no matter what treatment is performed and no matter how expertly that treatment is delivered, there is always a risk of keloids returning. It's very important to have close followup with whomever is treating your keloids so that any possible recurrence can be managed immediately. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Keloids are active scars that can be addressed with a combination of treatments, including IIT, laser, and surgery.  Our office specializes in scar treatments and we ask patients to apply Plato's Scar Serum, and recommend surgical procedures less often than a combination of lasers and IIT. Raffy Karamanoukian MD FACS

For lumpy scar tissue such as keloids or hypertrophic scars, injecting kenalog/cortisone (sometimes with liquid nitrogen preceding it) is the treatment of choice, or sometimes a 5-FU/kenalog mixture. In your case, excising the deep scarring lumpiness may be beneficial, but I'd still try the injection first as its simpler and safer, and excision always carries the risk of the keloid returning.