Effective Treatment of Keloids with Three-Dose Moderate-Strength Intralesional Triamcinolone Acetonide (TAC) Regimen

Abstract

Background: The most devastating consequence of any injury is scar formation. Among all the surgical specialties, plastic surgery faces the worst dilemma as patients expect it to be the scar-less surgery.
Objectives: This study aims to set an effective dose of triamcinolone acetonide intralesional injection to achieve successful results in the treatment of keloids.
Methods: A prospective interventional study was conducted in the Department of Plastic Surgery, Shaikh Zayed Hospital Lahore for 2 years. Triamcinolone acetonide was injected intralesional at a dose of 4mg/cm2 every 4th week. The improvement in scar appearance, pain, and itch were measured using Vancouver Scar Scale (VSS), Visual Analog Scale (VAS), and the St Andrew's itch egg scale, respectively up to 12 months of therapy.
Results: Among the 40 patients, 12 were males and 28 were females. The mean age of patients was 32.8 years and the most common sites were the chest, earlobes, and back. There was a substantial progressive improvement in VSS and VAS scores over one year. A significant reduction in pruritus was also observed in the patients. No recurrence was noted at the end of 12 months.
Conclusions: A moderate-strength dose of 4mg/cm2 as a single intralesional injection of triamcinolone acetonide every four weeks is effective in decreasing the size of keloids and relieving the symptoms such as pain and itching.