Is there an otc treatment/cream for keloids on ear piercings? Also will sea salt soaks help it go down? Or is my only option a steroid injection??

Yes. If it is small, you can use compression earrings which are clip-ons with a large surface area that exceeds the diameter of the keloid. Try to get the king that have silicone surfaces in contact with the skin. These are avail. online & used to be marketed as Glori earrings. Better, combine this treatment with excision by a plastic surgeon.