Treatment of Keloids: A Meta-analysis of Intralesional Triamcinolone, Verapamil, and Their Combination

Keloids are skin lesions of abnormal and excessive scar proliferation that have no agreed upon gold standard of therapy. Extensive research in this area has shown that both intralesional triamcinolone and verapamil are effective in their treatment. METHODS: A review of these two treatment modalities was conducted via an extensive search of existing literature published in PubMed, Scopus Libraries, and Science Direct databases using keywords “keloid,” “verapamil,” “triamcinolone,” “intralesional,” “treatment,” and “corticosteroid” published between 1996 and 2021. From these included studies, clinical trials that directly compared the effects of intralesional triamcinolone and verapamil from 2008 to 2021 were included in a meta-analysis. Lastly, the minimal current research pertaining to a potential future direction of their combination was described. RESULTS: Over 30 publications were included in this literature review to describe the current state of keloid treatment and outline the advantages and disadvantages of intralesional triamcinolone and verapamil. Eight of these studies were included in the meta-analysis which had varying results. In all studies, greater improvement was seen in the triamcinolone acetonide group compared with the verapamil group. However, these improved results were associated with a higher rate of adverse effects. CONCLUSIONS: When comparing the modalities of triamcinolone acetonide and verapamil for keloid treatment, triamcinolone acetonide shows more significant and rapid improvement compared with verapamil; however, there are also increased adverse effects. Minimal combination studies of these treatments have shown that perhaps using them together can augment their mechanisms without the unwanted side effects.