Intralesional Corticosteroids

Compare To Other Treatments

What Is It?

This treatment consists of injecting a corticosteroid, normally triamcinolone acetonide, directly into the raised scar in order to reduce the size and thickness of the scar.

This procedure is normally repeated multiple times (most commonly 4 to 8 times or more) in 2-week intervals. You should see gradual results with each session. After your last session, your scar(s) should continue to improve over time. However, in some cases, scars may grow back after treatment.

Good or Excellent Response

Strength of Evidence
1
2
3
4
5
58% of patients achieved a good (>50%) or excellent (>75%) improvement in scarring

Scar Height Reduction

Strength of Evidence
1
2
3
4
5
Average 54% reduction in scarring

Scar Volume Reduction

Strength of Evidence
1
2
3
4
5
Average 71% reduction in scarring

Mean improvement in VSS total score

Strength of Evidence
1
2
3
4
5
Average 61% reduction in scarring

Mean improvement in VSS pigmentation score

Strength of Evidence
1
2
3
4
5
Average 40% reduction in scarring

Mean improvement in VSS height score

Strength of Evidence
1
2
3
4
5
Average 64% reduction in scarring

Mean improvement in VSS pliability score

Strength of Evidence
1
2
3
4
5
Average 81% reduction in scarring

Mean improvement in VSS vascularity score

Strength of Evidence
1
2
3
4
5
Average 66% reduction in scarring
▸ Based on These Clinical Studies & Trials
▾ Based on These Clinical Studies & Trials
  1. Harsono, A. D. et al. Clinical evaluation of intralesional umbilical cord-derived mesenchymal stem cells, conditioned medium and triamcinolone acetonide injection for keloid treatment: A pilot study. Int Wound J (2023) doi:10.1111/iwj.14460.
  2. Haghani‐Dogahe, Z., Hadadi, R., Esmailzadeh, M. & Mobayen, M. Comparing intralesional triamcinolone and verapamil‐triamcinolone injections in keloids: A single‐blinded randomised clinical trial. International Wound Journal iwj.14314 (2023) doi:10.1111/iwj.14314.
  3. Cohen, A. J. et al. Combination cryotherapy and intralesional corticosteroid versus steroid monotherapy in the treatment of keloids. J of Cosmetic Dermatology 22, 932–936 (2023).
  4. Bik, L., Elmzoon, I., Wolkerstorfer, A., Prens, E. P. & Van Doorn, M. B. A. Needle-free electronically controlled jet injection with corticosteroids in recalcitrant keloid scars: a retrospective study and patient survey. Lasers Med Sci 38, 250 (2023).
  5. Tawaranurak, N., Pliensiri, P. & Tawaranurak, K. Combination of fractional carbon dioxide laser and topical triamcinolone vs intralesional triamcinolone for keloid treatment: A randomised clinical trial. International Wound Journal 19, 1729–1735 (2022).
  6. Lembo, F., Cecchino, L. R., Parisi, D. & Portincasa, A. The objective evaluation of triamcinolone acetonide efficacy in keloids management using Antera3D® imaging system. Scars, Burns & Healing 8, 205951312211377 (2022).
  7. Serag-Eldin, Y. M. A., Mahmoud, W. H., Gamea, M. M. & Hegab, D. S. Intralesional pentoxifylline, triamcinolone acetonide, and their combination for treatment of keloid scars. J Cosmet Dermatol (2021) doi:10.1111/jocd.14305.
  8. El-Dayem, D. H., Nada, H. A., Hanafy, N. S. & Elsaie, M. L. Laser-assisted topical steroid application versus steroid injection for treating keloids: a split side study. J Cosmet Dermatol 20, 138–142 (2021).
  9. Belie, O., Ugburo, A. O., Mofikoya, B. O., T Omidiji, O. A. & Belie, M. F. A comparison of intralesional verapamil and triamcinolone monotherapy in the treatment of keloids in an African population. Niger J Clin Pract 24, 986–992 (2021).
  10. Taweepraditpol, S. & Udkhamtiang, W. Comparison of efficacy between triamcinolone and mixture of lidocaine-triamcinolone on keloid volume reduction: a randomized, double blinded, prospective study. JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND 103, 22–27 (2020).
  11. Reddy, C. V. P. K. & A, S. A comparative study on treatment of keloid with triamcinolone versus 5-fluorouracil and triamcinolone. International Surgery Journal 7, 1373–1377 (2020).
  12. Park, J. H. & Chang, H. Cocktail therapy including bleomycin and verapamil as a promising treatment choice for keloid scars. Arch Aesthetic Plast Surg 26, 99–104 (2020).
  13. Marques, T. F., Santos, M. F., Silva, I. da L., Lorenzini, F. K. & Manzoni, A. P. D. da S. Infiltração intralesional de corticosteroide x laser fracionado ablativo associado a drug delivery de corticosteroide no tratamento de queloides: um estudo comparativo. Surgical & Cosmetic Dermatology 12, 264–269 (2020).
  14. Manzoor, H., Tahir, K., Nasir, A., Mufti, S. & Shehzad, A. Comparison of efficacy of intralesional 5-fluorouracil alone, intralesional triamcinolone acetonide alone and intralesional triamcinolone acetonide with 5-fluorouracil in management of keloids. Journal of Pakistan Association of Dermatologists 30, 282–285 (2020).
  15. Kumar, B. P. et al. A comparative study of therapeutic efficacy between intralesional steroids and cryotherapy in the management of keloids. Journal of Dental and Medical Sciences 19, 19–24 (2020).
  16. Kaushal, V., Kumar, S., Brar, B. K. & Singh, A. Comparative evaluation of therapeutic efficacy and safety of intralesional triamcinolone acetonide injection vs intralesional radiofrequency with intralesional triamcinolone acetonide in treatment of keloids. Dermatologic Therapy 33, e13919 (2020).
  17. Hewedy, E.-S. S., Sabaa, B. E.-S. I., Mohamed, W. S. & Hegab, D. S. Combined intralesional triamcinolone acetonide and platelet rich plasma versus intralesional triamcinolone acetonide alone in treatment of keloids. J Dermatolog Treat 1–7 (2020) doi:10.1080/09546634.2020.1730742.
  18. Gamil, H. D., Khattab, F. M., El Fawal, M. M. & Eldeeb, S. E. Comparison of intralesional triamcinolone acetonide, botulinum toxin type A, and their combination for the treatment of keloid lesions. J Dermatolog Treat 31, 535–544 (2020).
  19. Srivastava, S., Kumari, H. & Singh, A. Comparison of fractional CO2 laser, verapamil, and triamcinolone for the treatment of keloid. Adv Wound Care (New Rochelle) 8, 7–13 (2019).
  20. Shin, J., Cho, J. T., Park, S. I. & Jung, S. N. Combination therapy using non-ablative fractional laser and intralesional triamcinolone injection for hypertrophic scars and keloids treatment. Int Wound J 16, 1450–1456 (2019).
  21. Rasaii, S. et al. Intralesional triamcinolone alone or in combination with botulinium toxin A is ineffective for the treatment of formed keloid scar: a double blind controlled pilot study. Dermatol Ther 32, e12781 (2019).
  22. Khan, H. A., Sahibzada, M. N. & Paracha, M. M. Comparison of the efficacy of intralesional bleomycin versus intralesional triamcinolone acetonide in the treatment of keloids. Dermatol Ther 32, e13036 (2019).
  23. Khalid, F. A. et al. Comparison of efficacy and safety of intralesional triamcinolone and combination of triamcinolone with 5-fluorouracil in the treatment of keloids and hypertrophic scars: randomised control trial. Burns 45, 69–75 (2019).
  24. Hietanen, K. E. et al. Treatment of keloid scars with intralesional triamcinolone and 5-fluorouracil injections - a randomized controlled trial. J Plast Reconstr Aesthet Surg 72, 4–11 (2019).
  25. Alexander, S., Girisha, B. S., Sripathi, H., Noronha, T. M. & Alva, A. C. Efficacy of fractional CO2 laser with intralesional steroid compared with intralesional steroid alone in the treatment of keloids and hypertrophic scars. J Cosmet Dermatol 18, 1648–1656 (2019).
  26. Srivastava, S., Patil, A., Prakash, C. & Kumari, H. intralesional triamcinolone acetonide, 5-fluorouracil, and their combination in treatment of keloids. World J Plast Surg 7, 212–219 (2018).
  27. Garg, A. M. et al. The efficacy of intralesional triamcinolone acetonide (20mg/ml) in the treatment of keloid. International Surgery Journal 5, 868–872 (2018).
  28. Azimi Alamdari, H., Davarnia, G., Herizchi Ghadim, H. & Asal, S. Intralesional cryotherapy versus intralesional corticosteroid and 5-fluorouracil in the treatment of hypertrophic scars and keloids: a clinical trial. Crescent Journal of Medical and Biological Sciences 5, 215–221 (2018).
  29. Aggarwal, A., Ravikumar, B. C., Vinay, K. N., Raghukumar, S. & Yashovardhana, D. P. A comparative study of various modalities in the treatment of keloids. Int J Dermatol 57, 1192–1200 (2018).
  30. Abedini, R. et al. Comparison of intralesional verapamil versus intralesional corticosteroids in treatment of keloids and hypertrophic scars: a randomized controlled trial. Burns 44, 1482–1488 (2018).
  31. Zamanian, A., Nokandeh, M., Behrangi, E., Fazel, Z. & Zahra, A. Comparing efficacy and tolerability of triamcinolone and verapamil in treatment of hypertrophic scars and keloids. Journal of Skin and Stem Cell 4, 1–4 (2017).
  32. Saleem, F. et al. Comparison of efficacy of intralesional 5-fluorouracil plus triamcinolone acetonide versus intralesional triamcinolone acetonide in the treatment of keloids. J Pak Assoc Dermatol 27, 114–119 (2017).
  33. Nor, N. M., Ismail, R., Jamil, A., Shah, S. A. & Imran, F. H. A randomized, single-blind trial of clobetasol propionate 0.05% cream under silicone dressing occlusion versus intra-lesional triamcinolone for treatment of keloid. Clin Drug Investig 37, 295–301 (2017).
  34. Chen, X.-E. et al. Combined effects of long-pulsed neodymium-yttrium-aluminum-garnet laser, diprospan and 5-fluorouracil in the treatment of keloid scars. Exp Ther Med 13, 3607–3612 (2017).
  35. Acosta, S. et al. Effectiveness of intralesional triamcinolone in the treatment of keloids in children. Pediatr Dermatol 33, 75–79 (2016).
  36. Uzair, M., Butt, G., Khurshid, K. & Pal, S. S. Comparison of intralesional triamcinolone and intralesional verapamil in the treatment of keloids. Our Dermatol Online 6, 280–284 (2015).
  37. Shaarawy, E., Hegazy, R. A. & Abdel Hay, R. M. Intralesional botulinum toxin type A equally effective and better tolerated than intralesional steroid in the treatment of keloids: a randomized controlled trial. J Cosmet Dermatol 14, 161–166 (2015).
  38. Payapvipapong, K., Niumpradit, N., Piriyanand, C., Buranaphalin, S. & Nakakes, A. The treatment of keloids and hypertrophic scars with intralesional bleomycin in skin of color. J Cosmet Dermatol 14, 83–90 (2015).
  39. Khan, M. A., Bashir, M. M. & Khan, F. A. Intralesional triamcinolone alone and in combination with 5-fluorouracil for the treatment of keloid and hypertrophic scars. J Pak Med Assoc 64, 1003–1007 (2014).
  40. Aluko-Olokun, B., Olaitan, A. A., Ladeinde, A. L. & Oginni, F. O. The facial keloid: a comparison of treatment outcome between intralesional steroid injection and excision combined with radiotherapy. Eur J Plast Surg 37, 361–366 (2014).
  41. Ahuja, R. B. & Chatterjee, P. Comparative efficacy of intralesional verapamil hydrochloride and triamcinolone acetonide in hypertrophic scars and keloids. Burns 40, 583–588 (2014).
  42. Bilal, M. Clinical outcome of intralesional corticosteroid versus intralesional Verapamil in the treatment of post burn Keloid scars of the head and neck region. Pak J Surg 29, 263–268 (2013).
  43. Saha, A. K. & Mukhopadhyay, M. A comparative clinical study on role of 5-flurouracil versus triamcinolone in the treatment of keloids. Indian J Surg 74, 326–329 (2012).
  44. Sadeghinia, A. & Sadeghinia, S. Comparison of the efficacy of intralesional triamcinolone acetonide and 5-fluorouracil tattooing for the treatment of keloids. Dermatol Surg 38, 104–109 (2012).
  45. Prabhu, A., Sreekar, H., Powar, R. & Uppin, V. M. A randomized controlled trial comparing the efficacy of intralesional 5-fluorouracil versus triamcinolone acetonide in the treatment of keloids. Journal of the Scientific Society 39, 19 (2012).
  46. Darougheh, A., Asilian, A. & Shariati, F. Intralesional triamcinolone alone or in combination with 5-fluorouracil for the treatment of keloid and hypertrophic scars. Clin Exp Dermatol 34, 219–223 (2009).
  47. Anchlia, S., Rao, K. S., Bonanthaya, K. & Vohra, D. Keloidoscope: in search for the ideal treatment of keloids. J Maxillofac Oral Surg 8, 366–370 (2009).
  48. Koc, E., Arca, E., Surucu, B. & Kurumlu, Z. An open, randomized, controlled, comparative study of the combined effect of intralesional triamcinolone acetonide and onion extract gel and intralesional triamcinolone acetonide alone in the treatment of hypertrophic scars and keloids. Dermatol Surg 34, 1507–1514 (2008).
  49. Kelemen, O., Hegedus, G., Kollár, L., Menyhei, G. & Seress, L. Morphological analysis of the connective tissue reaction in linear hypertrophic scars treated with intralesional steroid or silicone-gel sheeting. A light and electron microscopic study. Acta Biol Hung 59, 129–145 (2008).
  50. Berman, B. et al. Evaluating the tolerability and efficacy of etanercept compared to triamcinolone acetonide for the intralesional treatment of keloids. J Drugs Dermatol 7, 757–761 (2008).
  51. Asilian, A., Darougheh, A. & Shariati, F. New combination of triamcinolone, 5-fluorouracil, and pulsed-dye laser for treatment of keloid and hypertrophic scars. Dermatol Surg 32, 907–915 (2006).
  52. Manuskiatti, W. & Fitzpatrick, R. E. Treatment response of keloidal and hypertrophic sternotomy scars: comparison among intralesional corticosteroid, 5-fluorouracil, and 585-nm flashlamp-pumped pulsed-dye laser treatments. Arch Dermatol 138, 1149–1155 (2002).
  53. Yosipovitch, G., Widijanti Sugeng, M., Goon, A., Chan, Y. H. & Goh, C. L. A comparison of the combined effect of cryotherapy and corticosteroid injections versus corticosteroids and cryotherapy alone on keloids: a controlled study. J Dermatolog Treat 12, 87–90 (2001).
  54. Tan, E., Chua, S. & Lim, J. Topical silicone gel sheet versus intralesional injections of triamcinolone acetonide in the treatment of keloids — a patient-controlled comparative clinical trial. Journal of Dermatological Treatment 10, 251–254 (1999).

Side Effects

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Medium-high side effects and adverse reactions

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