From the FDA Drug Label
For intramuscular or intra-articular use only KENALOG-40 40 mg per 10 mL Injectable Suspension 1 mL Single-Dose Vial 5 mL Multiple-Dose Vial 10 mL Multiple-Dose Vial
The recommended dosage for keloid scars is not explicitly stated in the drug label. However, considering the available syringe sizes (1 mL, 5 mL, 10 mL), a 1 mL syringe can be used to inject triamcinolone for keloid scars, as it is a single-dose vial option.
- Key consideration: The label does not provide specific guidance on the treatment of keloid scars, so caution should be exercised when making clinical decisions. 1
From the Research
For injecting keloid scars with triamcinolone, a 1ml syringe is generally preferred over a 3ml syringe. The 1ml syringe allows for more precise dosing and better control during the injection procedure, which is particularly important when treating keloid scars that may require small amounts of medication in specific areas. Typically, triamcinolone acetonide is used at concentrations ranging from 10-40 mg/ml depending on the size, location, and thickness of the keloid, as supported by studies such as 2. The injection should be performed using a 27-30 gauge needle to minimize discomfort and tissue trauma. When administering the injection, insert the needle into the body of the keloid and inject the medication slowly until slight blanching occurs. Multiple small injections throughout the keloid are often more effective than a single large injection. Treatments are usually repeated every 3-4 weeks until the desired result is achieved.
Some key considerations include:
- Starting with lower concentrations (10-20 mg/ml) is advisable for facial keloids or in patients with darker skin tones to minimize side effects such as skin atrophy, hypopigmentation, and telangiectasia, as noted in 3.
- The use of triamcinolone acetonide has been shown to be effective in reducing the size of keloid scars compared to untreated controls, as demonstrated in 4.
- Combination therapies, such as the use of triamcinolone acetonide with 5-fluorouracil, may offer benefits in terms of reduced side effects and improved efficacy, as suggested by 3.
Overall, the choice of syringe size and injection technique should be guided by the specific needs of the patient and the characteristics of the keloid scar, with the goal of minimizing morbidity, mortality, and improving quality of life.