{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:53:09Z","timestamp":1790074389172,"version":"4.0.1"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hypertrophic scars and keloids are fibroproliferative conditions that are resistant to treatment and recur often. The effectiveness and safety of glucocorticoid-based treatments and their combinations in the treatment of keloid disease were objectively assessed in this systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>42 randomized and comparative clinical studies were considered. Intralesional, topical, or aided glucocorticoid delivery were eligible treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The use of corticosteroids alone in intervention methods (SMD\u202f=\u202f1.28; 95% CI: 1.05\u20131.51;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05; I\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f43%). The use of 5-FU-based treatments yielded the same results (SMD\u202f=\u202f1.15; 95% CI: 0.97\u20131.34;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05) with very low level of inconsistency. The laser treatment approach significantly improved the scar condition (SMD\u202f=\u202f0.99; 95% CI: 0.81\u20131.16;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). CCD interventions had been significant changes and improvements (SMD\u202f=\u202f1.07; 95% CI: 0.97\u20131.18;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05; I\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f47%). Techniques with and without delivery, such as steroids + 5-FU, laser-assisted delivery, microneedling, or cryotherapy-assisted corticosteroid delivery, provided consistently better results. The GRADE evaluation indicated that the certainty of evidence was poor for microneedle and cryotherapy-aided techniques, medium for recurrence rate, cosmetic results, and negative consequences, and excellent for scar volume decrease, pain, and pruritus relief. The adverse outcomes, primarily telangiectasia and moderate atrophy, were temporary and self-resolving.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The best and safest treatment for keloid management is intralesional TAC, based upon the data at hand. The mainstay of clinically proven scar therapy is still multimodal, glucocorticoid-centered regimens that show consistent therapeutic outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1749329","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T05:45:42Z","timestamp":1768196742000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Efficacy and safety of glucocorticoid-based therapies in the management of keloids: a systematic review and meta-analysis of clinical outcomes"],"prefix":"10.3389","volume":"12","author":[{"given":"Kun","family":"Zhu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuhe","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Xiong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.burns.2018.08.011","article-title":"Comparison of efficacy and safety of intralesional triamcinolone and combination of triamcinolone with 5-fluorouracil in the treatment of keloids and hypertrophic scars: randomised control trial","volume":"45","author":"Khalid","year":"2019","journal-title":"Burns"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/j.bjps.2018.05.052","article-title":"Treatment of keloid scars with intralesional triamcinolone and 5-fluorouracil injections\u2013a randomized controlled trial","volume":"72","author":"Hietanen","year":"2019","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"ref3","volume-title":"Assessment of dose related response of intra-lesional triamcinolone acetonide in the treatment of keloid scars at Kenyatta National Hospital: a clinic based randomized control study Kenya: University of Nairobi","author":"Were","year":"2021"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.36849\/JDD.6197","article-title":"A randomized, double-blind, active-and placebo-controlled trial evaluating a novel topical treatment for keloid scars","volume":"20","author":"Fischer","year":"2021","journal-title":"J Drugs Dermatol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1080\/09546634.2020.1788703","article-title":"Intralesional betamethasone versus triamcinolone acetonide in the treatment of localized alopecia areata: a within-patient randomized controlled trial","volume":"33","author":"de Sousa","year":"2022","journal-title":"J Dermatol Treat"},{"key":"ref6","first-page":"17","article-title":"Treatment of small keloids using intralesional 5-fluorouracil and triamcinolone acetonide versus intralesional bleomycin and triamcinolone acetonide","volume":"14","author":"Sharma","year":"2021","journal-title":"J Clin Aesthet Dermatol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2757","DOI":"10.1007\/s00403-023-02662-x","article-title":"Recurrence rates in the treatment of keloids and hypertrophic scars with intralesional triamcinolone combined with other intralesional agents","volume":"315","author":"Rimmer","year":"2023","journal-title":"Arch Dermatol Res"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1507","DOI":"10.1111\/j.1524-4725.2008.34314.x","article-title":"An open, randomized, controlled, comparative study of the combined effect of intralesional triamcinolone acetonide and onion extract gel and intralesional triamcinolone acetonide alone in the treatment of hypertrophic scars and keloids","volume":"34","author":"Koc","year":"2008","journal-title":"Dermatologic Surg"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1093\/jbcr\/iraa057","article-title":"Within-patient, single-blinded, randomized controlled clinical trial to evaluate the efficacy of triamcinolone acetonide injections for the treatment of hypertrophic scar in adult burn survivors","volume":"41","author":"Nedelec","year":"2020","journal-title":"J Burn Care Res"},{"key":"ref10","volume-title":"Comparison of efficacy of intralesional 5-fluorouracil alone, intralesional triamcinolone acetonide alone and intralesional triamcinolone acetonide with 5-fluorouracil in management of keloids. 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