Intralesional triamcinolone versus 5-fluorouracil for keloids and hypertrophic scars: A randomized comparative clinical study

Keloids and hypertrophic scars lack a consistently effective and safe intralesional treatment and direct randomized comparisons between triamcinolone acetonide and 5-fluorouracil remain limited. Therefore, it is of interest to randomize clinical trial compared both agents in 100 patients treated over 12 weeks, evaluating scar height reduction, symptom improvement and adverse effects. Both treatments achieved significant scar flattening, with triamcinolone showing marginally greater mean height reduction. However, triamcinolone was associated with substantially higher rates of skin atrophy and telangiectasia, while 5-fluorouracil demonstrated a superior safety profile. Thus, we show 5-fluorouracil as a suitable first-line option for keloids and hypertrophic scars, especially in cosmetically sensitive areas.