Comparing Efficacy and Tolerability of Triamcinolone and Verapamil in Treatment of Hypertrophic Scars and Keloids

Hypertrophic scars (HSC) and Keloids are fibroproliferative dermal lesions resulting in excessive accumulation of extracellular matrix in the dermis and subcutaneous tissue. Corticosteroid, especially triamcinolone acetonide, injections may be the first line treatment for the prevention and treatment of keloids and HSC. Some drugs that inhibit calcium channels, such as verapamil, have also been effective in treatment of these lesions. The present study aimed to assess and compare the efficacy of these two treatment options in patients with HSC and keloids.

The study used a randomized, single blind, parallel design to compare the effect of verapamil in comparison with triamcinolone on the healing of HSC and keloids in two groups comprising 25 patients. Patients were randomly allocated using random numbers to receive intralesional injection of 1 mL of either verapamil (2.5 mg) or triamcinolone (20 mg) every 3 weeks for 3 months.

Downward trends in all lesion parameters including height of lesion, as well as the scores for erythema, pigmentation in both groups was revealed. The change in characteristics of the lesion within the treatment was independent to patients’ gender and age. Regarding drug - related complications, one case of atrophy was reported in triamcinolone group, however, not in the verapamil group.

Both verapamil and triamcinolone have significant therapeutic effects in decreasing the height of the lesion, improving erythema, improving the pliability of the lesion, and improving the hyperpigmentation. It seems that verapamil has less cost and side effects in comparison with triamcinolone, thus, it could be a good choice in treatment of keloids.