LAM FACIAL PLASTICS

Hi Dr. Lam

I have read thru all the previous posts. Would you please explain more about the use of 5FU for keloids vs steroids. I understand that steroid injections risks atrophy, whereas 5FU has little to no effect on surrounding healthy tissue and targets abnormal tissue..

Does 5FU actually effective in preventing the keloids from growing back once it has been flattened? If I understand it as an anti-cancer drug, it breaks down the mechanism that produces excess scar tissue.
or is it just a temporary therapy that requires indefinite injections as steroid is commonly known to temporary flatten and the keloid regrow gradually after stopping injections?

Appreciate your advice!

Sincerely,
Anthony

honestly, 5FU does not work well for keloids. it should be mixed with steroids. for anything less than a keloid, e.g., a hypertrophic scar, i rarely use steroids due to risk of atrophy but 5FU alone is not that effective for keloids. to be honest, steroids suck too. i really think you need an excellent excision by someone who does a lot of keloids followed by timed radiation starting no later than 24 hours after the excision of the keloid. that raises success rates from 20% to 95%.
s.

hey dr lam,

if a patient is not having success with steroids alone, is it possible for the steroid and 5-fu combination to be more effective? i've had treatments of steroids with initial improvement, but over time the scars would become raised again. thanks!

For keloids, no. 5FU is not of any major benefit. Surgery plus timed radiation is the solution.