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5-Fluorouracil Treatment of Problematic Scars

Haurani, Mounir J. M.D.; Foreman, Kenneth M.D.; Yang, James J. Ph.D.; Siddiqui, Aamir M.D.

Plastic & Reconstructive Surgery: January 2009 - Volume 123 - Issue 1 - pp 139-148
doi: 10.1097/PRS.0b013e3181904d1b
Reconstructive: Trunk: Original Articles

Background: Keloids and hypertrophic scars can be uncomfortable, disfiguring, and aesthetically undesirable. Anecdotal reports suggest that low-dose intralesional fluorouracil can be used to treat these undesirable scars.

Methods: Using a prospective case series protocol, both keloid and hypertrophic scar patients were included. Keloid patients underwent excision followed by a series of treatments with intralesional 5-fluorouracil into the healing scar to prevent recurrence (n = 32). The hypertrophic scar patients were treated with the same series of injections without scar excision to both control symptoms and improve scar appearance (n = 21). The primary outcome measures were scar volume and a symptom questionnaire. Patients were followed for 1 year after completing the injection treatments.

Results: In the keloid group, the recurrence rate was 19 percent at 1-year follow-up for this group of patients who had failed previous corticosteroid injection therapy. In the hypertrophic scar group, 14 percent did not respond to the series of injections. In this group, there was a median volume decrease of 50 percent maintained for 1 year after injection therapy was terminated.

Conclusions: Intralesional fluorouracil is a safe and effective means of controlling problem scars in terms of both recurrence and symptom control. Benefits were maintained for at least 1 year after completion of therapy. Intralesional 5-fluorouracil should be considered another option for patients suffering from problematic scars.

Detroit, Mich.; and Huntsville, Ala.

From the Departments of Surgery and Biostatistics and Research Epidemiology and the Division of Plastic Surgery, Henry Ford Hospital; and Alabama Surgical Associates.

Received for publication December 20, 2007; accepted July 24, 2008.

Presented at the 17th Annual Meeting of the Wound Healing Society, in Tampa, Florida, April 28 through May 1, 2007.

Disclosure: None of the authors has any commercial associations or financial disclosures that might pose or create a conflict of interest with information presented in this article.

Aamir Siddiqui, M.D.; Division of Plastic Surgery, K-16; Henry Ford Hospital; 2799 West Grand Boulevard; Detroit, Mich. 48202;

©2009American Society of Plastic Surgeons