Keloids are abnormal growths of scar tissue that can form at the site of a wound or injury. Triamcinolone acetate injections are commonly used to treat keloids, but some cases do not respond well to this treatment or experience recurrence. Recently, intralesional bleomycin has shown promising results in keloid treatment.

Triamcinolone acetate injections are a standard treatment for keloids, but their efficacy varies, and recurrence rates can be high. Intralesional bleomycin has emerged as a potential alternative, but its effectiveness in combination with triamcinolone remains uncertain.

A recent study aimed to evaluate the efficacy of combining bleomycin and triamcinolone for refractory keloids. This study was published in the journal of Dermatologic Surgery by Mozafari and colleagues. A total of 33 patients with resistant keloids were enrolled in the study. They received a mixture of bleomycin (1 u/cc) and triamcinolone acetonide (13.3 mg/cc) injected intralesionally every 4 to 6 weeks for up to 6 cycles. The Japan Scar Scale (JSS) and physician's global assessment were used to evaluate clinical improvement, and side effects were recorded.
The key findings of the study were:
• The study included 33 patients (8 men, 25 women) with a mean age of 36.52 years.
• After treatment, all patients showed a significant decrease in total JSS scores compared to baseline (p < .001). 26 keloids (78.8%) exhibited excellent response (75%–100% flattening), 7 keloids (21.2%) showed fair response (25%–75% flattening), and none showed poor response (<25% flattening)
• Side effects included ulceration (33.3%), hyperpigmentation (33.3%), hypopigmentation (15.15%), secondary infection (33.3%), and telangiectasia (15.15%).
The combination of bleomycin and triamcinolone proved to be effective in treating refractory keloids, with the majority of patients showing significant improvement. This therapy offers a promising option for individuals who have not responded well to traditional treatments. However, side effects such as ulceration and hyperpigmentation were observed and should be monitored closely during treatment.
Reference:
Mozafari, N., Mollaabasi, F., Mansouri, P., & Robati, R. M. The combined application of bleomycin and triamcinolone for treating refractory keloids. Dermatologic Surgery,2023;10.1097/DSS.0000000000004056. https://doi.org/10.1097/dss.0000000000004056