What is the recommended frequency for administering intralesional steroid injections for the treatment of keloids?

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From the Research

Steroid injections for keloids should be administered every 4-6 weeks, as this frequency has been shown to be effective in reducing the size and symptoms of keloids, with a trend towards preventing recurrences 1. The most commonly used steroid is triamcinolone acetonide (Kenalog), with concentrations ranging from 10-40 mg/ml depending on the keloid's location and thickness.

  • Treatment usually continues for 3-6 sessions, though some patients may require maintenance injections every 6-12 months to prevent recurrence.
  • The procedure involves injecting the steroid directly into the keloid tissue using a small needle, which may cause temporary discomfort.
  • Side effects can include skin thinning, hypopigmentation, and telangiectasia (visible blood vessels), especially with higher concentrations or frequent injections.
  • Steroid injections work by suppressing inflammation and inhibiting collagen synthesis, which helps reduce the size and symptoms of keloids.
  • The treatment should be performed by a dermatologist or other qualified healthcare provider who can adjust the frequency and concentration based on your individual response and the keloid's characteristics.
  • A study comparing the effectiveness of triamcinolone acetonide, 5-fluorouracil, and their combination for the treatment of keloids found that the combination of triamcinolone acetonide and 5-fluorouracil offered a balanced benefit of faster and more efficacious response with lesser adverse effects 2.
  • However, the most recent and highest quality study recommends administering intralesional steroid injections every 4-6 weeks, as this frequency has been shown to be effective in reducing the size and symptoms of keloids, with a trend towards preventing recurrences 1.

References

Research

Treatment of ear keloids: algorithm for a multimodal therapy regimen.

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2017

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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