The treatment of choice for keloids is usually an injection of corticosteroid drugs such as cortisone directly into the lesion. These injections cause the keloid to become atrophic, or thinner, and are repeated every three to four weeks until the keloid has been resolved to the individual's satisfaction. Other therapies, include laser treatment or radiation therapy, and topical treatments are undergoing study.

Surgery is often used in combination with corticosteroid injections. The injections are given for several weeks, and then the keloid is surgically removed. The injections are then continued for several weeks. Surgical removal of the keloid may also be used in conjunction with radiation therapy, which delivers small amounts of radiation to the affected area.

Another surgical option is cryosurgery, in which liquid nitrogen is used to freeze the tissues in the keloid. The treatment may need to be repeated to remove as much of the keloid as possible; however, cryosurgery prevents keloids from recurring in about 70% of patients.

Newer approaches include silastic gel sheeting, which makes use of pressure to flatten the keloid. The gel is applied and kept securely in place with tape, cloth, or an Ace bandage. The dressing is to be changed every seven to 10 days for as long as 12 months.

Finally, researchers are now studying a type of tape that has been soaked with steroids, which are released slowly into the keloid, causing it to thin over time.

Newer treatments include injections of interferon directly into the keloids, and local application of 5% imiquimod cream, which induces the skin where it is applied to produce interferon. The imiquimod cream is reported to significantly lower the risk of keloid recurrence.