What therapies do you recommend for preventing keloid recurrence after surgical resection?  

For earlobe keloids specifically, we have had reasonable results with a mixture of 40mg/ml triamcinolone mixed with 50mg/ml 5FU in a 1:1 ratio. This is injected day of keloid removal, then every 4 weeks for at least the first 6 months. No more than 0.1-0.3 mL per session. The treatments can be space...

Surgery followed by a short course of radiation therapy can reduce the rate of keloid recurrence to less than 10%. There are multiple protocols for the radiation dosing but most range from 15-20 Gy divided into several daily fractions. Mankowski et al., PMID 28177974

Over the last few years, I have gradually leaned more towards Shave Debulking + anywhere from ILK 40 to ILK 40 + 5FU in a mix ranging from 1:1 to 1:4. This is repeated Q4-6 weeks for several months, and then I have patients call for add-on appointments if they can sense that the keloidal tissue is ...