Background: Earlobe keloids are a cosmetically and symptomatically bothersome clinical problem with frequent recurrence despite various treatments including surgical excision and intralesional injection of corticosteroids. Objective: The aim of this study was to compare the results and recurrence of earlobe keloids after various postexcisional adjuvant therapies and to identify the most effective postoperation adjuvant therapy. Methods: We retrospectively evaluated 36 patients with earlobe keloids (n=71) who underwent core excision and a suprakeloidal flap using photographs. One group did not have adjuvant therapy, one group was treated with adjuvant triamcinolone intralesional injection (TRA/ILI), and another group was treated with postoperative irradiation. Results: Among treated 71 keloids, 18 lesions (25.4%) recurred; 42.9% (12/28) of the operation-only group and 19.4% (6/31) of TRA/ILI group showed recurrence. The adjuvant radiation therapy group had no recurrence. The difference in recurrence rate was statistically significant. Conclusion: Postexcisional adjuvant therapy was more effective than excision monotherapy for keloid treatment, and radiation therapy had more sustained effects than that of TRA/ILI.