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Treatment of inflamed hypertrophic scars using intralesional 5-FU

Over 9 years, one physician found that injections of 5-fluorouracil into inflamed, raised scars were effective and safe, and worked best when mixed with low-dose steroid and combined with pulsed dye laser.

1999
Dermatol Surg
253
Citations, NIH iCite
1
Authors
2
Topics

Overview

Raised scars and keloids can follow injury or surgery, and many treatments have been used with mixed success. The author reports his 9-year experience injecting 5-fluorouracil (5-FU) into inflamed hypertrophic scars, alone and with low-dose steroid plus pulsed dye laser. Results are shown through case reports.

Findings

  • 9-year experience of one author, shown with case reports.
  • 5-FU used at 50 mg/cc, and mixed with Kenalog (1 mg/cc), with pulsed dye laser at the same time.
  • Frequent early injections (once to three times weekly) were more effective, then spaced out (weekly to monthly) as scars stabilized and resolved.
  • The 5-FU and Kenalog mix appeared more effective and less painful than 5-FU alone.
  • Adding pulsed dye laser at the same visits as the injections was most effective.
  • The author concludes intralesional 5-FU appears effective and safe, and calls for further study.
  • The abstract gives no patient numbers or measured scar outcomes.

What it means for a patient

  • Any surgical incision, including a facelift incision, can form a raised, red scar. Injection treatment is one option.
  • In this author's experience, early frequent injections, then less frequent ones, worked better than infrequent treatment.
  • A mix of 5-FU with a small dose of steroid, along with laser, was the most effective approach he used.
  • This is one physician's experience with case reports, not a controlled trial. The author states more study is needed.

Why this paper matters

It reported 5-FU injection, alone and combined with low-dose steroid and pulsed dye laser, as a treatment for inflamed hypertrophic scars. It describes a dosing schedule from frequent to monthly injections. Cited 253 times (NIH iCite, 2026-09-25).

Terms

  • Hypertrophic scar: a raised scar that stays within the edges of the original wound.
  • Keloid: a raised scar that grows beyond the edges of the original wound.
  • 5-fluorouracil (5-FU): a drug that slows cell growth, used here to reduce scar tissue.
  • Intralesional: injected directly into the scar.
  • Kenalog (triamcinolone): a corticosteroid used to flatten scars.
  • Pulsed dye laser: a laser that targets blood vessels, used to reduce scar redness.
  • Corticosteroid: a drug that reduces inflammation.

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