TREATMENT OF KELOIDS AND HYPERTROPHIC SCARS BY COMBINED CRYOTHERAPY AND INTRALESIONAL TRIAMCINOLONE

Objectives: To evaluate the outcomes of combining cryotherapy and intralesional triamcinolone in the treatment of keloids and hypertrophic scars. Methods: 60 patients (31 males and 29 females) with 266 keloids and 34 hypertrophic scars were enrolled and divided equally into 2 groups. Group 1 were treated with cryotherapy in combination with intralesional triamcinolone 20 mg/ml (treated group) and group 2 (control group) were treated with intralesional triamcinolone alone 20mg/ml. The duration of treatment for both groups was 12 weeks with 4 sessions. The assessment of therapeutic responses was made at baseline, after 4, 8, 12 and 16 weeks. Results: After treatment, in terms of thickness, the keloids and hypertrophic scars responded significantly better to combined cryotherapy and triamcinolone than triamcinolone alone (p < 0.05): 1.3% had excellent improvement, 46.4% had good improvement and 41.2% had moderate improvement and 11.1% had little improvement. Meanwhile, in control group, the percentage for each degree of improvement were 1.4%, 16.7%, 55.6% and 26.4%, respectively. Ultrasound revealed an average reduction of scar height in treated group (2.4 ± 1.3 mm), which was higher than the result in control group (1.8 ± 0.4 mm) (p < 0.05). Side effects in treated group including pain, blister, hypopigmentation, longer healing time, acne, and troublesome with menstrual cycles were sometimes were reported. No significant side effects were reported in both groups. Conclusion: Combining cryotherapy with injection of intralesional steroids appeared to be superior in comparision with intralesional steroids alone in treatment of keloids and hypertrophic scars without severe side effects.