From the Research
Triamcinolone acetonide is the preferred corticosteroid for keloid injections due to its potent anti-inflammatory and anti-fibrotic properties, which effectively reduce keloid size and symptoms. The typical regimen involves intralesional injections of triamcinolone at concentrations of 10-40 mg/mL, with lower concentrations used for facial keloids and higher concentrations for thicker keloids on the trunk or extremities, as supported by a study published in 2021 1.
Key Considerations for Treatment
- Injections are usually administered every 3-4 weeks until satisfactory improvement is achieved, typically requiring 3-6 sessions.
- The medication works by suppressing inflammatory mediators, inhibiting fibroblast proliferation, and reducing collagen synthesis, which are key factors in keloid formation.
- When performing the injection, the medication should be delivered directly into the keloid tissue using a 27-30 gauge needle, distributing small amounts throughout the lesion until slight blanching occurs.
- Patients should be informed about potential side effects including skin atrophy, hypopigmentation, telangiectasia, and pain at the injection site.
Combination Therapy for Optimal Results
For optimal results, triamcinolone injections are often combined with other treatments such as silicone sheeting, pressure therapy, or surgical excision for comprehensive keloid management, as discussed in a study from 2018 2. Additionally, combining triamcinolone with other agents like pentoxifylline may enhance efficacy while reducing side effects, as noted in the 2021 study 1.
Recent Findings and Recommendations
A recent study from 2019 3 compared the efficacy of intralesional 5-fluorouracil (5-FU) and triamcinolone injections, finding no significant difference in remission rates but higher local adverse effects with triamcinolone. However, the most recent and highest quality study from 2021 1 supports the use of triamcinolone, especially when combined with pentoxifylline, for improved outcomes and reduced side effects. Therefore, based on the most recent evidence, triamcinolone acetonide, potentially in combination with other treatments, remains the preferred choice for keloid injections.