Comparison of efficacy of intralesional 5-fluorouracil plus triamcinolone acetonide versus intralesional triamcinolone acetonide in the treatment of keloids


  • Farah Saleem
  • Zahida Rani
  • Bushra Bashir
  • Faria Altaf
  • Khawar Khurshid
  • Sabrina Suhail Pal


Keloids, 5-fluorouracil, triamcinolone acetonide, Vancouver Scar Scale


Objective To compare efficacy of intralesional 5-fluorouracil (5-FU) plus triamcinolone acetonide (TCA) versus intralesional TCA alone in the treatment of keloids. Methods The study included 100 patients with keloids. Patients were divided into two groups. Randomization was done through lottery method. For each 1 cm area, group A was given intralesional 5-FU 50 mg/ml (0.9ml) plus TCA 40mg/ml (0.1ml) after every 4 weeks and group B was given intralesional TCA 40mg/ml (0.1ml) after every 4 weeks for total period of 12 weeks. Administration of the drugs was continued till the keloid flattened or for a maximum period of 12 weeks. Follow-up was done every 4 weeks for total period of 12 weeks after the administration of last injection. Decrease in total score using Vancouver Scar Scale was calculated. Results After the completion of study mean reduction in Vancouver Scar Score was -71.18 ± 8.69 in the intralesional 5-FU plus TCA group as compared to -50.80 ± 8.59 in the intralesional TCA group (p=0.001). 5-FU + TCA was efficacious in 98% of cases (group A) and TCA alone in 62% of cases (group B). No serious adverse effects were noticed in either group. Conclusion Intralesional 5-FU plus TCA is significantly better than intralesional TCA alone in the treatment of keloids. 


Juckett G, Adams HH. Management of keloids and hypertrophic scars. Am Fam Physician. 2009;80:253-60.

Hatamipour E, Mehrabi S, Hatamipour M, Shirazi HRG. Effects of combined intralesional 5-fluorouracil and topical silicone in prevention of keloids: A double blind randomized clinical trial study. Acta Medica Iranica. 2011;49:127-30.

Margaret Shanthi FX, Ernest K, Dhanraj P. Comparison of intralesional verapamil with intralesional triamcinolone in the treatment of hypertrophic scars and keloids. Indian J Dermatol Venereol Leprol. 2008;74:343-8.

Scharffetter-Kochanek K. Hypertrophic scars and keloids. In: Burgdorf WHC, Plewig G, Wolff HH, Landhaler M, editors. Braun-Falco’s Dermatology. 3rd edition. Heidelberg: Springer Medizin Verlag; 2009. P.698-9.

Ogawa R. The most current algorithms for the treatment and prevention of hypertrophic scars and keloids. Plast Reconstr Surg. 2010;125:557-68.

Davison SP, Dayan JH, Clemens W, Wang SSA, Crane A. Efficacy of intralesional 5-fluorouracil and triamcinolone in the treatment of keloids. Aesthetic Surgery J. 2009;29:406.

Prabhu A, Sreekar H, Powar R, Uppin VM. A randomized controlled trial comparing the efficacy of intralesional 5-fluorouracil versus triamcinolone acetonide in the treatment of keloids. J Sci Soc. 2012;39:19-25.

Sharma S, Bassi R, Gupta A. Treatment of small keloids with intralesional 5-fluorouracil alone vs. intralesional triamcinolone acetonide with 5-fluorouracil. J Pak Assoc Dermatol. 2012;22:35-40.

Faermonti R, Bond J, Erdnan D, Levinson H. A review of scar scales and scar measuring devices. Eplasty. 2010;10:43.

Berman B, Perez OA, Konda S, Kohut BE, Viera MH, Delgado S et al. A review of the biologic effects, clinical efficacy, and safety of silicone elastomer sheeting for hypertrophic and keloid scar treatment and management. Dermatol Surg. 2007;33:1291-1303.

Gauglitz GG, Korting HC, Pavicic T, Ruzicka T, Jeschke MG. Hypertrophic scarring and keloids: Pathomechanisms and current and emerging treatment strategies. Mol Med. 2011;17:113-25.

Copcu E, Sivrioglu N, Oztan Y. Combination of surgery and intralesional verapamil injection in the treatment of the keloid. J Burn Care Rehabil. 2004;25:1-7.

Fitzpatrick RE. Treatment of inflamed hypertrophic scars using intralesional 5-FU. Dermatol Surg. 1999;5:224-32.

Wendling J, Marchand A, Mauviel A, Verrecchia F. 5-Fluorouracil blocks transforming growth factor-beta-induced alpha 2 type I collagen gene (COLIA2) expression in human fibroblasts via c-Jun NH2-terminal kinase / activator protein-1 activation. Mol Pharmacol. 2003;64:707-13.

Apikian M, Goodman G. Intralesional 5-fluorouracil in the treatment of keloid scars. Australas J Dermatol. 2004;45:140-3.

Shaffer JJ, Taylor SC, Cook-Bolden F. keloid scars: A review with a critical look at therapeutic options. J Am Acad Dermatol. 2002;46 (Suppl):S63-97.

Manuskiatti W, Fitzpatrick RE. Treatment response of keloid and hypertrophic sternotomy scars: comparison among intralesional corticosteroid, 5-fluorouracil, and 585-nm flashlamp-pumped pulsed-dye laser treatments. Arch Dermatol. 2002;138:1149-55.

Kuo YR, Jeng SF, Wang FS, Chen TH, Huang HC, Chang PR et al. Flashlamp pulsed dye laser (PDL) suppression of keloid proliferation through down-regulation of TGF-beta1 expression and extracellular matrix expression. Lasers Surg Med. 2004;34:104-8.

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. 2006;32:907-15.




How to Cite

Saleem F, Rani Z, Bashir B, Altaf F, Khurshid K, Pal SS. Comparison of efficacy of intralesional 5-fluorouracil plus triamcinolone acetonide versus intralesional triamcinolone acetonide in the treatment of keloids. J Pak Assoc Dermatol [Internet]. 2018Jul.11 [cited 2024Feb.26];27(2):114-9. Available from:



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