The clinical analysis of the combination of cryosurgery and intralesional corticosteroid for keloid or hypertrophic scars

Abstract

Background: Keloids and hypertrophic scars are benign fibrous growths which usually occur in predisposed individuals after trauma. Numerous modalities have been used to treat keloids and hypertrophic scars, but the final results have been so far unsatisfactory. Objective: The purpose of this study was to evaluate the effect of the combination of cryosurgery and intralesional corticosteroid for treatment of these scars. Methods: Thirty patients, aged 17 to 45 years old, with keloids or hypertrophic scars(mean duration, 6.4 years) were treated using solid CO2, followed by intralesional injection of triamcinolone acetonid(13.3 mg/ml). Two freeze-thaw cycles per lesion were employed. Freezing time was chosen arbitrarily from 7 to 20 sec depending on the characteristics of each scar. Results: The results are summarized as follows: 1. Excellent and good results were achieved in 57% of all subjects on average, 77% of those who were treated more than 3 times, and 48% of those treated less than twice. 2. The keloid of less than 2 years duration showed better results than older ones. 3. No recurrence was seen in 63% of patients, but partial recurrence in 21% of patients and complete recurrence in 10% were observed. Lesions on the trunk showed less improvement(p<0.05) and were more recurrent than other lesions. 4. There were complications in 9 patients, such as hyperpigmentation(6), hypopigmentation(1), infection(1) and telangiectasia(1). Conclusion: Cryosurgery and intralesional corticosteroid injections produced synergistic advantages. A combination of these modalities might be an effective treatment modality in keloids and hypertrophic scars.