A comparison of the combined effect of cryotherapy and corticosteroid injections versus corticosteroids and cryotherapy alone on keloids: a controlled study

Abstract

BACKGROUND: Treatment modalities for keloids, which are commonly found in Asians, include intralesional corticosteroid injections and cryotherapy as well as a combination of these two modalities. Few studies have been performed in a controlled fashion to evaluate the efficacy of these treatments. OBJECTIVE: A controlled study, to evaluate the combined effect of intralesional corticosteroid injection with cryotherapy vs. intralesional corticosteroid or cryotherapy alone. METHODS: Ten patients completed the study: eight patients had at least three keloids and two had two keloids. Patients were treated for at least three sessions 4 weeks apart. The outcome of the lesions was compared between the treatments regarding the thickness of the lesion using a caliper and photographic assessment, and the presence of itch and pain before and after treatment using a visual analogue scale. RESULTS: In terms of thickness, the keloids responded significantly better to combined cryotherapy and triamcinolone vs. triamcinolone alone or cryotherapy alone (P < 0.001). Pain intensity was significantly lowered with all treatment modalities; however, itch was lowered only with the combined treatment and intralesional corticosteroid alone. No significant side effects were noted with any of the treatments and no re-occurrence of keloids was noted with the combined therapy. CONCLUSION: Combined injection of intralesional steroids with cryotherapy appears to be superior to other current modalities.