Triamcinolone injection treating keloid scar

Keloid Scars: Can a Simple Injection Really Make a Difference?

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Beau Callahan in Health & Wellness October 2026 • 4 min read.

"Exploring the effectiveness of triamcinolone injections in reducing keloid size and promoting cell death."


Keloids are more than just scars; they are a fibroproliferative disorder affecting a significant percentage of the population. Unlike normal scars that fade over time, keloids can grow beyond the original wound site, causing concern. Understanding what triggers and sustains keloid formation is crucial, and researchers have been exploring various treatments to manage and reduce these persistent skin growths.

One promising avenue of treatment involves triamcinolone, a corticosteroid known for its anti-inflammatory properties. Injecting triamcinolone directly into keloid scars has been a common practice for decades, aiming to reduce inflammation and potentially shrink the scar tissue. While the approach is widely used, questions remain about its effectiveness and the specific mechanisms through which it acts.

This article delves into a study assessing the impact of triamcinolone injections on keloid scars, focusing on changes in size and the induction of apoptosis, or programmed cell death, within the scar tissue. By understanding the results of this research, individuals grappling with keloids can make more informed decisions about their treatment options.

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Impact and Prevalence

Keloid scars can affect people differently in size, appearance, symptoms, and impact on daily life. Their visibility or discomfort may lead some people to seek medical advice. The available information here does not provide a specific prevalence estimate or broader impact statistics.

Treatment Options

Treatment choices for keloids generally depend on the scar and the individual. Common approaches may aim to reduce the scar's size, appearance, or symptoms rather than guarantee complete removal. Outcomes and limitations can vary, so treatment decisions are best discussed with a qualified clinician.

How Keloids Were Understood

Keloids are raised scars that can develop after skin injuries, including acne, insect bites, injections, piercings, burns, hair removal, scratches, and bumps. They may appear months to a year after the injury and grow beyond the original wound. Their tissue involves an overgrowth of granulation tissue containing type III collagen, which is slowly replaced by type I collagen. Keloids may look like firm, rubbery lesions or shiny, fibrous nodules, with coloring ranging from pink or skin-colored to red or dark brown, and they generally do not fade over time.

Triamcinolone Injections for Keloid Treatment: Do They Really Work?

Triamcinolone injection treating keloid scar

A recent study investigated the effects of triamcinolone injections on keloid scars, examining changes in length, height, and thickness, as well as the number of cells undergoing apoptosis (cell death). The study involved fifteen patients with ear keloids, divided into two groups. One group underwent keloid excisions, while the other received three sessions of triamcinolone injections before excision.

The key measurements included the keloid scars' length, height, and thickness, taken before triamcinolone injection and before surgery. Researchers also analyzed surgical specimens to quantify cells and assess apoptosis. Here’s a breakdown of the methods used:

  • Study Design: Prospective, controlled, randomized, single-blinded clinical trial.
  • Participants: Fifteen patients with ear keloids.
  • Groups:
    • Group 1: Keloid excision only (seven patients).
    • Group 2: Keloid excision after three triamcinolone injections (eight patients).
  • Triamcinolone Injection: 1 ml of triamcinolone hexacetonide (20mg/ml) injected into the central region of the keloid scar every three weeks.
  • Measurements: Keloid length, height, and thickness measured before injections and before surgery.
  • Apoptosis Analysis: Microscopic examination of surgical specimens to identify and quantify apoptotic cells.
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What Reviews Cover

Current informational reviews discuss keloid scar causes, symptoms, infection, treatment, and removal. They may also include pictures to help readers recognize the condition. This source summary does not provide a specific new therapy, study result, or treatment comparison.

Limits of Treatment

A simple injection should not be understood as a guaranteed solution for every keloid. Treatment response may differ between people and scars, and recurrence or incomplete improvement can remain concerns. The available source material does not establish a single approach that works reliably in all cases.

Comparing Approaches

Keloid treatments can differ in their goals, methods, and expected results. Some may focus on reducing size or appearance, while others may be considered alongside additional care. Without comparative evidence in the supplied sources, no treatment can be ranked as universally superior.

The results indicated no significant difference in apoptosis between the two groups. The apoptotic index in the excision-only group was 56.82, while in the triamcinolone group, it was 68.55 (p=0.0971). Although the triamcinolone group showed a slight increase in apoptosis, it was not statistically significant. Additionally, the keloid dimensions in the triamcinolone group reduced by 10.12% in length, 11.94% in height, and 15.62% in thickness, but these reductions were also not statistically significant (p>0.05).

What This Means for Keloid Treatment

The study suggests that while triamcinolone injections may lead to some reduction in keloid size, they do not significantly increase apoptosis within the scar tissue. Therefore, triamcinolone infiltration may not be the sole solution for keloid management. Further research is needed to explore the drug's mechanisms of action and determine its effectiveness in combination with other treatments, offering hope for more effective keloid management strategies in the future.

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A Balanced View

Keloid injections may be useful for some people, but their value depends on the individual scar and clinical context. A realistic discussion should consider potential improvement as well as uncertainty about the final result. Professional evaluation can help determine whether an injection is appropriate.

What Comes Next

Future progress may depend on developing treatments that reduce keloid growth more consistently and limit recurrence. Research may also clarify which patients are most likely to benefit from particular therapies. The supplied sources do not identify a specific emerging treatment or forecast.

Access and Care

Keloid care can involve more than choosing a single procedure. People may face challenges related to diagnosis, access to dermatology services, treatment costs, and the need for follow-up. These broader issues can influence whether recommended care is obtained and maintained.

Living With Keloids

A keloid can be a visible and persistent reminder of an earlier injury. Its appearance, size, or symptoms may affect confidence and everyday comfort, although the experience differs from person to person. Decisions about treatment should therefore account for both physical findings and the individual's concerns.

The trial at a glance

Study designRandomised or controlled trial[1]
PopulationPatients with ear keloids[1]
DurationThree sessions with three week intervals[1]
ComparisonGroup 1 underwent keloid excisions; Group 2 underwent excisions after triamcinolone infiltration[1]
Main outcomeKeloid dimensions and number of cells undergoing apoptosis[1]
Times cited9[1]

How this result fits with later reports

A 2023 evidence review cited this trial as finding no significant difference in keloid dimensions at six-month follow-up, placing its result among evidence that did not show a clear dimensional advantage.[2]

Later reviews also described beneficial laser outcomes, while a randomized comparison with 5-FU found no significant remission-rate difference and reported more skin atrophy in the TAC group. These findings concern distinct comparisons and outcomes, not a single ranking of treatments.[3] [4]

Questions this trial leaves open

  • Would the measured effects differ with longer follow-up, when recurrence and lasting changes could be assessed?[1] [5]
  • How well do results from ear keloids apply to scars in other locations or to different patient groups?[1]
  • Would other outcome scoring systems change how treatment effects are evaluated?[5]

Sources

  1. Effect of triamcinolone in keloids morphological changes and cell apoptosis (FapUNIFESP (SciELO), 2015)
  2. Keloid treatments: an evidence-based systematic review of recent advances (2023)
  3. A scoping review of the treatment of hypertrophic scars and keloids (2022)
  4. Treatment of keloid scars with intralesional triamcinolone and 5-fluorouracil injections - a randomized controlled trial. (pubmed.ncbi.nlm.nih.gov)
  5. Comparing intralesional triamcinolone and verapamil‐triamcinolone injections in keloids: A single‐blinded randomised clinical trial (pmc.ncbi.nlm.nih.gov)

About this Article -

Written with AI assistance from published research, and reviewed by the Mystum team. See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1590/0100-69912015003008, Alternate LINK

Title: Effect Of Triamcinolone In Keloids Morphological Changes And Cell Apoptosis

Subject: Surgery

Journal: Revista do Colégio Brasileiro de Cirurgiões

Publisher: FapUNIFESP (SciELO)

Authors: João Márcio Prazeres Dos Santos, Cláudio De Souza, Anílton César De Vasconcelos, Tarcizo Afonso Nunes

Published: 2015-06-01

Everything You Need To Know

1

What are keloid scars and how do they differ from normal scars?

Keloid scars are a fibroproliferative disorder, meaning they involve an excessive growth of fibrous tissue. Unlike normal scars that tend to fade over time, keloids can grow beyond the original wound site. This excessive growth is a key difference, making keloids more noticeable and potentially causing functional or cosmetic concerns. The article highlights that keloids affect a significant percentage of the population, emphasizing the importance of understanding their formation and treatment.

2

How do triamcinolone injections work to treat keloid scars?

Triamcinolone is a corticosteroid with anti-inflammatory properties. The injections are administered directly into the keloid scars with the aim of reducing inflammation, thereby potentially shrinking the scar tissue. The process involves injecting 1 ml of triamcinolone hexacetonide (20mg/ml) into the keloid scar every three weeks. The study explored the impact of these injections on keloid size and the induction of apoptosis (programmed cell death) within the scar tissue.

3

What were the key findings of the study regarding triamcinolone injections and keloid treatment?

The study, a prospective, controlled, randomized, single-blinded clinical trial, involved fifteen patients with ear keloids. It compared two groups: one undergoing keloid excision only and the other receiving three triamcinolone injections before excision. The study measured keloid length, height, and thickness, finding reductions in size in the triamcinolone group. However, these reductions were not statistically significant. The study also analyzed apoptosis, or cell death, and found no significant difference between the groups. Specifically, the apoptotic index was not significantly different between the excision-only group and the triamcinolone group.

4

What is the significance of apoptosis in the context of keloid treatment, and did the study find that triamcinolone effectively induced it?

Apoptosis, or programmed cell death, is a mechanism the body uses to eliminate unwanted cells. In keloid treatment, promoting apoptosis within the scar tissue could potentially reduce the keloid's size. The study aimed to determine if triamcinolone injections increased apoptosis. The results showed that, while the triamcinolone group had a slight increase in apoptosis, it was not statistically significant. Therefore, the study suggests that triamcinolone infiltration may not be the sole solution for keloid management. This finding highlights the complexity of keloid treatment and the need for further research into the mechanisms of action and effectiveness of different treatments.

5

What does the research suggest about the overall effectiveness of triamcinolone injections for keloid treatment, and what are the implications for future treatment strategies?

The study suggests that, while triamcinolone injections may lead to some reduction in keloid size, they do not significantly increase apoptosis within the scar tissue. The study highlights that the reductions in keloid dimensions were not statistically significant, implying that triamcinolone may not be the definitive solution for keloid management on its own. It calls for further research to explore the mechanisms of action of triamcinolone and its effectiveness when combined with other treatments. This opens the door for exploring combination therapies and innovative approaches to provide more effective strategies for keloid management, offering more promising outcomes for individuals grappling with keloids.

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