EFFICACY OF COMBINED INTRALESIONAL TRIAMCILONE AND CRYOTHERAPY FOR TREATMENT OF KELOID

Abstract

Background: Keloids are a challenging dermatological condition that can cause physical discomfort and emotional distress.  

Objective: To determine the efficacy of combined intralesional triamcinolone acetonide and cryotherapy in the treatment of keloids in patients with Fitzpatrick skin types IV and V.

Methodology: This quasi-experimental study was conducted at the Dermatology Outpatient Department, Fauji Foundation Hospital, Rawalpindi, from December 2024 to May 2025. A total of 88 patients aged 18–75 years with clinically diagnosed keloids and skin types IV or V were enrolled through non-probability consecutive sampling. Each patient received three sessions of intralesional triamcinolone acetonide (40 mg/ml) followed by cryotherapy at 4-week intervals. Keloid size and symptoms (pain, itching, redness, hardness) were recorded at baseline and 4 weeks after the final session.

 Results: The mean age was 34.7 ± 10.8 years; 40.9% were males and 59.1% were females. The mean baseline keloid size was 3.8 ± 1.2 cm, which reduced to 1.6 ± 0.9 cm post-treatment (p < 0.001), representing a mean percentage reduction of 58.2 ± 15.7%. A ≥ 50% reduction in keloid size was achieved in 76.1% of patients. Symptom prevalence also decreased significantly: pain from 52.3% to 13.6%, itching from 65.9% to 20.5%, redness from 55.7% to 17.0%, and hardness from 69.3% to 21.6% (all p < 0.001). Stratified analysis revealed significantly better responses in ear and chest keloids (p = 0.041), while age, gender, duration, and preceding insult type were not significantly associated with treatment outcome.

 Conclusion: Combined intralesional triamcinolone and cryotherapy is a safe, effective, and affordable treatment option for keloids in patients with Fitzpatrick skin types IV and V, offering substantial lesion reduction and symptom relief. It is particularly effective for ear and chest keloids.