Steroids have been long used in treatment of various skin disorders. Injecting steroids directly inside the keloid tissue, known as intralesional injection, is a commonly used method of treating small keloids. This treatment however, is only partially effective. Triamcinolone acetonide is the most commonly used drug for treatment of keloids.
Dr. Sexton reported the efficacy of intradermal injection of this fluorinated prednisolone derivative in 1960 . Applied intralesionally, triamcinolone acetonide is one of the most widely used treatments for keloids, whether alone or in combination with another type of treatment.
Steroid injections are not as effective as we would like them to be. About one third of patients give up treatment because of pain and lack of immediate improvement. Our own recent IRB approved keloid survey was launched in November 2011 with the goal of capturing detailed information about this disorder directly from patients [www.KeloidSurvey.com] . As of May 7, 2012, 221 patients with keloid disorder had completed this survey. 127 adults have reported that they have been previously treated with steroid.
Graphs below show summary of the findings reported by the patients. This study shows that steroids work in about one third of pateints and for most part, their efficacy is temporary with about 16% chance of causeing worsening the keloids.
Furthermore steroids injections can also cause worsening of keloids in some patients Keloids are often resistant to treatment and have high recurrence rates. Repeated corticosteroid injections can be very painful and may cause various complications such as loss of normal skin tissue, discoloration and Cushingâ€™s syndrome, a condition that is due to excess systemic exposure to steroids.
Not all keloids respond to intralesional steroid injections. Some keloids are â€œSteroid Sensitiveâ€ and others are â€œResistant to Steroidsâ€.
In the video below case, you can see how I inject the length of a scar with steroids.