External Medicine
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Keloids
TREATMENT
Intralesional Therapies
Intralesional Insulin
Intralesional Insulin Is Superior to Intralesional Botulinum Toxin-A in the Treatment of Keloids. Dermatol Surg. 2025. PMID: 40035685.
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Objective: To compare the effectiveness of intralesional insulin and botulinum toxin A (BTX-A) in treating keloids, with corticosteroids as a reference treatment.
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Methods: 63 patients with keloids were randomized into 3 equal groups: Group A: Intralesional insulin; Group B: Intralesional BTX-A; Group C: Intralesional corticosteroids. Treatments were administered monthly for 4 months. Effectiveness was assessed using the Patient and Observer Scar Assessment Scale (POSAS) and volume reduction measurements.
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Key Findings: All treatments significantly reduced keloid volume: Insulin: 66.6% reduction; BTX-A: 25.3% reduction; Corticosteroids: 75% reduction. Insulin and corticosteroids outperformed BTX-A in improving: Pigmentation, Thickness, Surface area, Relief. Corticosteroids were most effective overall but caused side effects (atrophy, telangiectasia) in 62% of patients. Insulin showed strong efficacy with only mild, reversible hypoglycemia as a side effect. BTX-A was less effective but may be useful as an adjunct therapy.
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Conclusion: Intralesional insulin is a safe, effective, and low-cost alternative to traditional steroid injections for treating keloids, and it outperforms BTX-A.