Atlas of Scar Treatment and Correction by Igor Safonov

Author:Igor Safonov
Language: eng
Format: epub
Publisher: Springer Berlin Heidelberg, Berlin, Heidelberg

Corticosteroid Injections

A suspension (crystalline) of 40 mg/ml triamcinolone acetonid or betamethasone sodium phosphate is used for intralesional injections. The maximal single dose for children ages 8–10 years is equal to 20 mg (beginning at 18 years, the dose is equal to 40 mg).

Contraindications to injection. Absolute: oncological diseases, pregnancy, lactation, and breast-feeding. Relative: kidney disease (pyelonephritis, glomerulonephritis); gastric ulcer and duodenal ulcer in the period of disease exacerbation.

Administration. This suspension is to be diluted with water for injections or with 2 % lidocaine hydrochloride injection. A 1- to 2-ml syringe and 27- to 30-G needle are used for such injections. The needle is introduced into the depth of the scar in the direction that must be as much parallel to the skin surface as possible (Fig. 2.26a). Injections are to be made from different points. To prevent atrophy of the skin, the needle bevel shall be directed upwards. The scar becomes lighter if the medicine is injected correctly (Fig. 2.26b). For prophylaxis of suprarenal gland atrophy, it is necessary to observe the interval between the procedures; the duration of such intervals is equal to 4–6 weeks. A course of treatment lasts from several months to several years. A positive dynamics is observed in 85–90 % of cases. Recurrences after complete disappearance of a keloid are observed in 5–10 % of cases. After 2–5 years, recurrences occur in 1–3 % of cases.

Fig. 2.26Intralesional corticosteroid injections (a) insert the needle parallel to the skin surface (b) enlightenment scar after correctly corticosteroids injection

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