Scar Improvement Enhanced With Intralesional Triamcinolone Acetonide Injection During Static Stage

Injection of intralesional triamcinolone acetonide is more effective during the static stage of pathologic scarring than during the early stage, according to study results published in the Journal of Cosmetic Dermatology.¹

The investigators sought to elucidate whether the effect of intralesional triamcinolone acetonide injection during the early stage of scarring differs from the effect during the static stage.

A total of 108 individuals (45 women and 63 men) with pathologic scars were enrolled in the study. The participants were divided into 2 groups based on the time of their first treatment following injury: the early-stage (Group A; ≤6 months after the injury; n=51) and the static-stage group (Group B; >6 months after the injury; n=57). Patients from both groups were then treated with intralesional triamcinolone acetonide injection.

The Vancouver Scar Scale (VSS) was used to evaluate the scars,² a durometer was used to measure scar hardness, and the Visual Analog Scale (VAS) was used to evaluate patients’ subjective feelings (ie, pruritus and pain). Treatment effectiveness was divided into 4 groups: (1) ineffective, <25%; (2) mildly effective, 25% to 50%; (3) moderately effective, 50% to 75%; and (4) very effective, ≥75%).

Based on effectiveness percentage, most of the scars were improved with respect to color, thickness, softness, and vascular distribution following treatment, with an effective rate of 87.2% (effectiveness percentage, >25%). In the moderately effective group, the overall efficacy in the static-stage group was statistically significantly superior to that in the early-stage group (P <.05).

Following the injection of triamcinolone acetonide, most scars improved significantly with respect to hardness, with an effective rate of 78.2% (effectiveness percentage, >25%). Moreover, in the moderately effective group, the overall efficacy of the static-stage arm was significantly superior to that of the early-stage arm (P <.05).

Following 1 to 2 courses of triamcinolone acetonide injections, most patients experienced significant alleviation or even total loss of pain and pruritus associated with their scars, with effective rates of 92.5% and 89.7%, respectively (effectiveness percentage, >25%).

The investigators concluded that the current study provides new clinical evidence for the optimization of drug therapy for pathologic scars. Intralesional injection of triamcinolone acetonide is effective for treating hypertrophic scars and keloids, and is capable of significantly improving clinical symptoms linked to pathologic scarring.

References

1. Song H, Tan J, Fu Q, Huang L, Ao M. Comparative efficacy of intralesional triamcinolone acetonide injection during early and static stage of pathological scarring [published online June 22, 2018]. J Cosmet Dermatol. doi:10.1111/jocd.12690

2. Nedelec B, Shankowsky HA, Tredget EE. Rating the resolving hypertrophic scar: comparison of the Vancouver Scar Scale and scar volume. J Burn Care Rehabil.
2000;21(3):205-212.