Comparison of Effectiveness of Intralesional Triamcinolone Acetonide with Fractional CO2 Laser Against Intralesional Triamcinolone Acetonide with Intralesional Verapamil in the Treatment of Keloids.

Background: Keloids are benign overgrowth of fibrous tissue extending beyond the original wound margin. The management of keloids remains challenging despite the various treatments available. Studies have shown that combination therapies are superior to monotherapy.

Aim and objective: To compare the effectiveness of intralesional triamcinolone acetonide with fractional CO2 laser against intralesional triamcinolone acetonide with intralesional verapamil in treating keloids.

Patients and methods: This study included 24 patients with single or multiple keloids. After obtaining consent, 12 patients each were allocated to either fractional CO2 with intralesional triamcinolone group (Group 1) or intralesional verapamil with intralesional triamcinolone group (Group 2). Keloid scars were assessed and scored according to the Vancouver scar scale (VSS) during each visit with serial photographs. The procedures were repeated at an interval of four weeks for a total of four sittings and participants were followed up for another six months.

Results: Both groups showed significant improvement in the clinical appearance of keloids. The overall response was better in Group 2. In VSS assessment, there was a faster and better rate of reduction in height with Group 2. Pliability and vascularity improved significantly and none had recurrences of keloid till the end of the study in both groups.

Limitations: Limitations of the study are the small sample size and short duration of follow-up.

Conclusion: Both the combination groups are safe and efficacious methods to treat keloid. Intralesional verapamil with triamcinolone showed better and faster clinical improvement compared to fractional CO2 laser with intralesional triamcinolone.