What is the maximal number of injections of intralesional (intralesional) corticosteroid (corticosteroid) for keloid treatment?

From the Guidelines

The maximal number of intralesional corticosteroid injections for keloid treatment is not explicitly stated in the provided guidelines, which focus on acne management rather than keloid treatment 1. However, based on general medical knowledge and practices for keloid treatment, the approach typically involves a limited series of injections.

• The treatment aims to reduce inflammation and fibroblast activity in the keloid.
• Commonly, triamcinolone acetonide is used, with concentrations varying based on the keloid's location and size.
• The decision on the number of injections should consider the balance between efficacy and potential side effects, such as skin atrophy or hypopigmentation.
• Given the context of the question and the absence of specific guidance from the provided evidence, a cautious approach would limit the number of injections to 3-4 per site, spaced 4-6 weeks apart, with careful monitoring for response and side effects.
• It's crucial to tailor the treatment to the individual patient, considering factors like keloid size, location, and the patient's overall health status.
• If the provided guidelines are strictly followed, there's no direct recommendation for keloid treatment with intralesional corticosteroids, as the guidelines primarily address acne management 1.

From the Research

Maximal Number of Injections for Keloid Treatment

• The maximal number of injections of intralesional corticosteroid for keloid treatment is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
• However, some studies provide information on the treatment duration and frequency of injections:
  • A study by 4 mentions that treatment was repeated at three-week intervals until keloid flattening was achieved or a maximum of 10 treatments were completed.
  • Another study by 3 reports that treatment intervals varied from weekly to monthly, with 4 weeks most frequently used.
• It is essential to note that the optimal number of injections and treatment frequency may vary depending on the individual patient and the specific treatment protocol being used 5, 6.

Treatment Protocols and Outcomes

• Different treatment protocols have been studied, including the use of triamcinolone acetonide, verapamil, and their combination 2, 3, 6.
• The outcomes of these treatments have been variable, with some studies reporting significant improvements in keloid symptoms and appearance 2, 4, 6.
• However, adverse effects have also been reported, particularly with the use of triamcinolone acetonide 3, 6.

Conclusion is not allowed, and the response should continue with more information

Additional Considerations

• The use of local anesthesia and the technique of injection may also influence the outcome of intralesional corticosteroid treatment for keloids 3, 5.
• Further research is needed to determine the optimal treatment protocol and to minimize adverse effects 2, 3, 6.