Answer:
Put briefly, surgical excision does not guarantee that a keloid will not recur. In fact, keloids frequently recur after excision even when it is supplemented with other forms of therapy such as intralesional injection of corticosteroids. Indications include failure of more conservative therapy, functional impairment due to the keloid, and aesthetic deformity significant enough to cause distress to the patient, though in these instances, the patient should be warned that recurrence is not only likely but may be more severe than the original keloid. Complaints of burning and itching can sometimes be relieved with intralesional steroids or antihistamines alone.