Hi and thanks for your question. Keloids can be very frustrating, both to suffer from, and to try to treat. One like yours looks like it can probably be excised in the office under local anesthesia. However, keloids have an extremely high rate of recurrence after removing them. One way to reduce the recurrence rate is by radiating them immediately after excision. This can be coordinated with a doctor who performs radiation therapy. Still, even with this combined approach, the recurrence rate is still around 50%. All things considered, it's probably worth trying, as excision and radiation are relatively minor procedures and downtime will be minimal. Good luck!With warm regards,Keith Blechman, MDPlastic and Reconstructive SurgeonNew York, NY