Comparison of intralesional 5-fluorouracil versus intralesional triamcinolone acetonide for keloid treatment: A prospective randomised double-blind controlled study

Keloid scars pose significant treatment challenges due to excessive collagen deposition, causing pain, functional impairment and psychological distress despite multiple available interventions. Therefore, it is of interest to compare intralesional 5-fluorouracil (5-FU, 50 mg/mL) versus triamcinolone acetonide (40 mg/mL) in 30 patients randomly assigned to two equal groups. Vancouver Scar Scale parameters (height, pliability, vascularity, pigmentation), pain (Visual Analogue Scale) and pruritus were assessed at treatment end and 2-month follow-up. Both treatments achieved significant VSS improvement (p<0.001), with 93.3% 5-FU and 100% triamcinolone patients reaching total VSS ≤5; 5-FU showed faster response (40% endpoint by session 5 vs 20%) and fewer adverse reactions. Intralesional 5-FU emerges as a superior, less toxic alternative to triamcinolone for keloid management, offering equivalent efficacy with quicker clinical response and better safety profile.