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Treatment of keloid and hypertrophic scars by intralesional corticosteroid injections

Treatment of keloid and hypertrophic scars by intralesional corticosteroid injections

Intralesional corticosteroid injection of crystalline suspension (f. ex. betamethasone or triamcinolone acetonide) to treat active keloids and old hypertrophic scars. Corticosteroid injections reduce collagen synthesis not only by inhibiting fibroblast mitosis (cells synthesizing collagen), but along with collagenase (collagen-resolving enzyme) concentration increase. Besides, steroids possess a strong anti-inflammatory action. Positive dynamics is observed in 50-100% of patients (Fig.1).

Fig.1. Treatment of hypertrophic scar after c-section before and after intralesional corticosteroid injections

The suspension is injected directly into the scar (Fig. 2). The injection of the suspension is painful, so that a local anesthetic can be used. The frequency and number of sessions varies depending on the activity and size of the scar.

Fig.2. Treatment of keloid scar. Intralesional injection of triamcinolone acetonide into the keloid

Contraindications to the administration. Absolute: cancer, pregnancy, lactation and breastfeeding. Relative: renal disease (pyelonephritis, glomerulonephritis), gastric ulcer and 12 duodenal ulcer during the exacerbation.