What is the Best Keloid Treatment?

Treatment of ear keloids can be a challenging problem, but can also be quite gratifying for the patient and surgeon when successful. Each patient is different, and for this reason, a visit with an experienced surgeon is recommended for an examination and personalized treatment plan.
In general, steroid injections can be very helpful for the treatment of keloids, both as a stand-alone treatment or as an adjunct to surgery. Steroid injections can be used pre-operatively to shrink the keloid and decrease the overall inflammatory pathway. They can also be used post-operatively to prevent the recurrence of the keloid.
Ultimately, many ear keloids do require surgical excision, which can often be performed under local anesthesia. In addition to steroid injections, pressure earrings can be helpful post-operatively to prevent recurrence. There are other medications that can be injected into the area as well, but are not used as commonly as steroids. 
Finally, in refractory cases, radiation therapy to the area can be effective, but this is generally reserved for patients with very extensive or recurrent keloids despite the treatments mentioned above.

some keloids respond well to corticosteroid injections, but others get too white in color. Some need excision and then corticosteroid injections and others can be frozen. There's no guarantee the keloid won't recur after treatment.

There are many treatments for keloids but the best treatment
really depends on the patient and their specific scar.  Most keloids are first treated by injecting a
steroid to reduce their substance and size. 
Once they are smaller and softer, scar excision or revision are
options.  In addition, radiation of the
keloid in combination with surgery may offer very good results in select
cases.  In lighter skins types one can
also consider intra-lesional cryotherapy. Your local board-certified
dermatologist or plastic surgeon should be able to review your specific needs
and make a plan of care that works best for you.