Combination of Radiofrequency and Intralesional Steroids in the Treatment of Keloids

Weshay, Ahmed Hany; Hay, Rania Abdel; Sayed, Khadiga S; Hawary, Marwa Safwat El; Nour-Edin, Faisal

doi:10.1097/dss.0000000000000360

Cited by 12 publications

(16 citation statements)

References 11 publications

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“…Fruth et al treated auricular keloids with RF ablation (1-7 treatments), half in combination with intralesional administration of triamcinolone, and saw improvement in 6/7 treated with combination therapy and 4/7 with RF ablation monotherapy [48]. A subsequent study saw improvement in 12 out of 13 lesions (92.3%), with only one patient requiring multiple treatments; the authors acknowledged that there was no explanation for the divergence between their results and those of Fruth et al [49] Further evaluation of combination therapy with RF ablation and steroid injection was found to decrease keloid volume (95.4% reduction), pain, and pruritus [50]. Support of these results was found in a comparison of triamcinolone, triamcinolone and hyaluronidase, verapamil, RF, and RF with triamcinolone.…”

Section: Radiofrequency (Rf) Ablationmentioning

confidence: 97%

A Review of Current Keloid Management: Mainstay Monotherapies and Emerging Approaches

Limmer

Glass

2020

Dermatol Ther (Heidelb)

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Commonly affecting those with skin of color, keloids are an aberrant wound response that leads to wound tissue expanding above and beyond the original cutaneous injury. Keloids are notoriously and particularly difficult to treat because of their tendency to recur after excision. The current standard of care is intralesional steroid (triamcinolone acetonide). However, because no therapy has yet proven to be fully curative, keloid treatments have expanded to include a number of options, from injections to multimodal approaches. This review details current treatment of keloids with injections (bleomycin, verapamil, hyaluronic acid and hyaluronidase, botulinum toxin, and collagenase), cryotherapy, laser, radiofrequency ablation, radiation, extracorporeal shockwave therapy, pentoxifylline, and dupilumab.

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Section: Radiofrequency (Rf) Ablationmentioning

confidence: 97%

A Review of Current Keloid Management: Mainstay Monotherapies and Emerging Approaches

Limmer

Glass

2020

Dermatol Ther (Heidelb)

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“…Similarly, studies with RF showed be er result when adjunc ve ILCS was used. 38 Three studies on RF reviewed here, all of which showed good result with no recurrence except one study where a small scar recurred in 10% of cases at fi ve year follow up. 15,37,38 However, none of the other studies did this long dura on follow up of fi ve years.…”

Section: Discussionmentioning

confidence: 73%

“…38 Three studies on RF reviewed here, all of which showed good result with no recurrence except one study where a small scar recurred in 10% of cases at fi ve year follow up. 15,37,38 However, none of the other studies did this long dura on follow up of fi ve years. Both the studies on PDT reviewed here used MAL as a photosensi zing agent and irradiated the lesions using a red light with a wave length of 630 nm and light dosage at 37 J/ cm2.…”

Section: Discussionmentioning

confidence: 73%

“…In 2015, Weshay AH et alpresented the study on the combined eff ect of RF and IL steroids in the treatment of keloids. 38 It was a pilot study on 18 pa ents who were subjected to three to four sessions of RF followed by IL steroid injec on. A signifi cant reduc on of volume of all lesions in all pa ents was noted, with a mean volume reduc on of 95.4%.…”

Section: Radiofrequencymentioning

confidence: 99%

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Upcoming Therapeutic Modalities for the Treatment of Keloids: An Update

Keyal¹,

Bhatta²

2019

Nepal J Dermatol Venereol & Leprol

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Introduction: Keloids are benign dermal tumors that generally form by local fibroblast proliferation and excessive collagen production following skin trauma. Several methods have been described for the treatment of keloid, often with suboptimal results and recurrences. Objective: To update literature that provides information regarding upcoming therapeutic modalities for the treatment of keloids, including lasers, radiofrequency (RF), photodynamic therapy (PDT), and ultraviolet A1 (UVA1) irradiation. Materials and Methods : A systematic review of the literature was performed for the original articles related to the treatment of keloids. The search terms ‘keloids’ and ‘lasers’ or ‘radiofrequency’ or ‘PDT’ or ‘UVA1’ was entered into a search of the National Library of Medicine’s PubMed Database. Result: The search returned a total of 188 sources, of which, 26 articles met our inclusion criteria. Conclusion: Combination approach is superior than solo therapy in the treatment of keloid. However, it is highly desirable that new emerging therapies undergo large-scale studies with long-term follow-up before being recommended conclusively as alternative therapies for the treatment of keloid. Moreover, lack of randomized clinical trials (RCTs) needs to be taken into consideration urgently.

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“…However, no statistically significant differences were found between the results for atrophic and hypertrophic scars, respectively. In the treatment of hypertrophic scars, some authors have reported good results with injected triamcinolone, [11][12][13] whereas atrophic scars appear to improve with the application of iontophoresis with retinoic acid (tretinoin). [14][15][16] In a previous study of atrophic and hypertrophic acne scars, we obtained attenuations of almost 60% by transepidermal delivery of cosmeceuticals with bioactive components and whitening substances (allantoin, bisabolol, sodium hyaluronate, glycosaminoglycans, dipotassium glycyrrhizate, vitamin B complex, vitamin C, and low molecular weight peptides).…”

Section: Discussionmentioning

confidence: 99%

Clinical and histological results in the treatment of atrophic and hypertrophic scars using a combined method of radiofrequency, ultrasound, and transepidermal drug delivery

Trelles¹,

Martínez-Carpio

2016

Int J Dermatology

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Scars are problematic for thousands of patients. Scarring is a natural part of the healing process after an injury. However, the appearance of a scar and its treatment depend on multiple factors and on the experience of the therapist and the options available. Despite a plethora of rapidly evolving treatment options and technical advances, the management of atrophic and hypertrophic scars remains difficult. Innovative technologies provide an attractive alternative to conventional methods in the treatment of scars. The purpose of this trial was to determine the clinical and histological results of a method of treatment that combines radiofrequency, ultrasound, and transepidermal drug delivery. This was a prospective study conducted on 14 patients with scars of different sizes, types, and characteristics. All patients underwent six treatment sessions with the Legato device. Atrophic scars were treated with retinoic acid and hypertrophic scars with triamcinolone. Photographs and biopsies were taken before treatment and at 6 months after the last treatment session. The scars improved significantly (P < 0.0001). The mean attenuation in the severity of scars was 67% (range: 50-75%), where 100% indicates complete disappearance of the scar. Clinical and histological images of scar tissue in six patients in whom attenuation in the range of 55-75% was achieved are shown. Biopsies show regenerative changes in the scar tissue, in both the epidermis and dermis. The method makes it possible to treat extensive, heterogeneous scars on different sites with good results that are similar and predictable.

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Combination of Radiofrequency and Intralesional Steroids in the Treatment of Keloids

Abstract: Radiofrequency tissue volume reduction combined with IL steroid is an effective treatment modality for keloids. It is an easy procedure with acceptable cosmetic outcome and less rate of recurrence.

Cited by 12 publications

References 11 publications

A Review of Current Keloid Management: Mainstay Monotherapies and Emerging Approaches

A Review of Current Keloid Management: Mainstay Monotherapies and Emerging Approaches

Upcoming Therapeutic Modalities for the Treatment of Keloids: An Update

Clinical and histological results in the treatment of atrophic and hypertrophic scars using a combined method of radiofrequency, ultrasound, and transepidermal drug delivery

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