THIS GUIDELINE publication is a compilation of recommendations for treatment of patients with common clinical presentations of keloid disorder. As you will notice throughout this volume, not all keloid patients present in a similar manner. Every patient presents a unique problem. Therefore, the treatment for each keloid lesion should be customized for each patient. Obviously, the first instinct in a young person who develops a keloid lesion is to have that lesion surgically removed. As documented in each Guideline, rushing into surgery will often result in worsening of the keloids - simply because keloid disorder is a progressive and multifocal disorder of skin. Our better understanding of basic facts about this chronic genetic ailment will guide us to more effective treatment choices.