Hypertrophic and keloidal scars: an approach to polytherapy

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Abstract
Cryotherapy and intralesional corticosteroids have been used separately or in combination as a treatment for hypertrophic and keloidal scars. The addition of silicone gel to the treatment schedule might be of interest. Twenty patients with hypertrophic and keloidal scars received two 15-s cycles (in total 30 s) of cryotherapy treatments at every session (once monthly for 12 months) with intralesional injections of trimcinolone acetonide 0.1% (10-40 mg/mL, once monthly for 3 months). Topical application of silicone gel was added three times daily (for 12 months). The control group included 10 patients who received treatment with silicone sheeting. After 1 year there was improvement in all the parameters studied, especially in terms of symptoms, cosmetic appearance and associated signs (P < 0.0001) compared to baseline and compared to the control group. Our study suggests that polytherapy may be an effective tool in the therapy of hypertrophic and keloidal scars.