Treatment of Keloids

Efficacy and Response Rates

• Intralesional corticosteroid injection can stimulate hair regrowth at the site of injection in patients with localized lesions, with better response in those with fewer lesions 1
• The American Academy of Dermatology recommends intralesional triamcinolone acetonide as the first-line therapy for keloid treatment, with the goal of flattening the keloid 2

Administration and Dosage

• The American Academy of Dermatology recommends administering intralesional triamcinolone acetonide at 40 mg/mL concentration, every 3-4 weeks until the keloid flattens, with a maximum of 4-6 sessions 2
• For facial or thin-skinned areas, diluting triamcinolone acetonide to 10-20 mg/mL may be considered to reduce the risk of atrophy 2

Side Effects and Complications

• Potential side effects of intralesional corticosteroid injection include fat and/or dermal atrophy, pigmentary changes, folliculitis, adrenal suppression, transient Cushingoid features, and failure to thrive 1, 3
• The risk of side effects can be minimized by using appropriate dosages and techniques, and by balancing efficacy with potential risks 2