Treatment of Inflamed Hypertrophic Scars Using Intralesional 5-FU

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Background.Hypertrophic scars and keloids may complicate wound healing secondary to trauma or surgery. A variety of treatment regimens have been used with a range of success.Objective.The purpose of this paper is to report the use of 5-fluorouracil (5-FU) intralesionally in treatment of inflamed hypertrophic scars, both as an individual agent as well as in conjunction with low-dose intralesional corticosteroids plus pulsed dye laser therapy.Methods.The author’s 9-year experience in the use of this agent in treating hypertrophic scars is summarized, and case reports are used to demonstrate its efficacy at 50 mg/cc as well as mixed with Kenalog (1 mg/cc) plus concomitant use of the pulsed dye laser.Results.Frequent initial injections (once to thrice weekly) were found to be more efficacious with decreasing frequency (weekly to monthly) during a period of stabilization and resolution of the scars. The combination of 5-FU and Kenalog appeared to be more effective and less painful. The addition of the pulsed dye laser treatments simultaneous with injection therapy was found to be most effective.Conclusion.The use of 5-FU intralesionally for treatment of hypertrophic scars appears to be both effective and safe. Further study is warranted.

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