Keloid, as a benign fibroblastic disease of the skin, is the result of excessive proliferation of fibroblasts and abnormal deposition of collagen during the process of skin trauma repair. Clinically, this disorder presents as a fibrous proliferation that protrudes beyond the surface of the skin beyond the margins of the original injury, affecting both function and aesthetics. In clinical treatment, the 32P radioactive patch is a well-established and effective treatment based on the biological effect of β-rays, which can penetrate keloid tissue, induce apoptosis of fibroblasts in the keloid, impede cell proliferation, and inhibit excessive collagen synthesis and deposition, and eventually achieve the desired therapeutic effect after a period of treatment. However, because radiation naturally decays over time and because keloids have variability in dose requirements and size from patient to patient, 32P radioactive patches usually need to be custom dispensed according to the patient's specific situation. This article will provide a detailed overview of the manufacturing process for 32P radioactive patch radiation applicators, methods of calculating radiopharmaceutical doses, as well as specific procedures and considerations for clinical application.