The Use of Corticosteroids to Treat Keloids: A Review

Abstract

Mechanisms for keloid formation include drastic changes in growth factor actions, collagen turnover, mechanical forces applied over the skin, and genetic and immunologic contributions. The use of corticosteroids to manage keloids increases basic fibroblast growth factor production while decreasing transforming growth factor-beta1 production by human dermal fibroblasts, endogenous vascular endothelial growth factor, and insulin-like growth factor-1. The use of corticosteroid injections is, to date, the core treatment available for the management of excessive tissue production in scars. Currently, the most effective and safe regimen for keloid management appears to be the use of corticotherapy-injection of intradermal steroids after a surgical excision.

Development, validation and testing of a human tissue engineered hypertrophic scar model

“…this result is in line with clinical results for 5FU and TC, since it is known that neither of these therapies can completely restore scar tissue to a normal skin phenotype in all patients (tab. 1) (Niessen et al, 1999;Roques and teot, 2008;Wang et al, 2009). Both standard therapeutics normalized only two parameters out of seven, indicating that for a therapeutic to be potentially effective, it should also partially normalize at least two parameters.…”

Combined effects of long-pulsed neodymium-yttrium-aluminum-garnet laser, diprospan and 5-fluorouracil in the treatment of keloid scars

“…Numerous mechanisms by which corticosteroids influence scar formation have been reported, including reduction of fibroblast proliferation, suppression of components involved in the inflammatory response, attenuation of pro-collagen and ground substance synthesis, and decreased endothelial budding (6). Despite the benefits of intralesional corticosteroids, several adverse effects have been reported, including altered pigmentation, telangiectasia, skin atrophy, injection pain, ulceration and cushingoid habitus (20). It has been suggested that the combined use of intralesional 5-FU and low-dose corticosteroid may lead to fewer intolerable side effects when compared to intralesional corticosteroid monotherapy (10).…”

Optimization of treatment and prevention of scars

“…Гормонотерапия келоидных и гипертрофических рубцов, а именно назначение кортикотропина и стерои-дов коркового слоя надпочечников (кортизона, гидрокор-тизона, кортизола), получила широкое распространение [73,77,98]. Наиболее эффективной она была после хирур-гического лечения [97]. Инъекции кортикостероидов ис-пользовались в трех направлениях: в качестве монотера-пии для радикального лечения келоидных рубцов, в соче-тании с хирургической операцией и для симптоматиче-ского лечения [57,87,89].…”