Treatment of inflamed hypertrophic scars using intralesional 5-FU

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.