Abstract
Keloid scars are a common yet poorly understood complication of wound healing that can cause a diminished quality of life. Currently, there is little agreement amongst the medical community regarding the best treatment modality for keloids. For this reason, we have created an updated review of the most successful combination therapies for keloid scars and compared their efficacy based on rates of recurrence following treatment. Additionally, these combination therapies have been compared with intralesional triamcinolone acetonide corticosteroid (TAC), which is considered the mainstay monotherapy for keloids. All combination therapies included in our review were shown to produce superior outcomes than TAC monotherapy. We have also found that certain combination therapies are known to produce superior results when used in specific anatomic locations. Intralesional TAC plus intralesional cryotherapy appeared to have the most promising results for non-auricular keloids, and the authors suggest considering this as a first-line treatment. Additionally, the use of surgical excision plus compression therapy achieved superior results for auricular keloids and should be considered first-line for keloids in these locations.
Highlights
BackgroundKeloid scars are a common yet poorly understood complication of wound healing that can cause a diminished quality of life
triamcinolone acetonide corticosteroid (TAC) injections used as monotherapy for keloids are associated with increased rates of recurrence and greater side effect profile when compared to combination therapy
Even studies that have found no significant difference in resolution or recurrence between TAC monotherapy versus TAC combination therapy have reported a reduction in deleterious side effects when TAC is utilized with additional therapy such as 5-FU [5]
Summary
Keloid scars are a common yet poorly understood complication of wound healing that can cause a diminished quality of life. Many factors have been correlated with a predisposition to keloid formation including specific HLA subtypes, blood type aII, Fitzpatrick skin types V-VI, and age from 10 to 30 years old [1]. Aspects of initial wound management have been correlated with the formation of keloid scars including delayed debridement, heavy inflammation, and excessive wound tension [1]. There is little agreement amongst the medical community regarding the best treatment modality for keloids. The goal of this review is to compare the most successful current keloid therapies in order to assist physicians in selecting the most appropriate regimen for their patients
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