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The pathogenesis of keloids remains obscure, and its treatment is troublesome. Comprehensive therapy is usually applied for its management in clinical settings. Surgical removal combined with radiotherapy or intralesional glucocorticoids is the first-line treatment for keloids. Radiotherapy, which includes superficial X ray therapy, electron beam therapy, etc, often has little carcinogenicity. Sillicon gel sheet and pressure therapy usually serve as the basic adjunctive treatment of keloids, which can soften and flatten keloids and improve subjective symptoms and have shown favorable efficacy in all stages of keloids. Effective drugs for keloids mainly include asiaticoside, alpha asiaticoside cream, imiquimod 5% cream, etc. Gene therapy as well as biological preparations may have an inviting prospect for the management of keloids. Satisfactory outcomes may be achieved by combined modality therapy with the above regimens following individual evaluation of conditions in patients with keloids.

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