Modality or treatment option	Response rate (%)	Recurrence rate (%)	Comments	Study design
Prevention
Preventive silicone sheeting as postsurgery care	0 to 75	25 to 36	Multiple preparations available; tolerated by children	Review of multiple case studies8
			Expensive; should be avoided on open wounds; poor study designs
Postsurgical intralesional corticosteroid injection (triamcinolone acetonide [Kenalog] 10 to 40 mg per mL at six-week intervals)	NA	0 to 100 (mean 50)	Patient acceptance and safety	Review of multiple case studies9
			May cause hypopigmentation, skin atrophy, telangiectasia
Postsurgical topical imiquimod 5% cream (Aldara)	NA	28	May cause hyperpigmentation, irritation	Case study12
Postsurgical fluorouracil, triamcinolone acetonide, and pulsed dye laser (best outcomes)	70 at 12 weeks	NA	Effective	Clinical trial13
			May cause hyperpigmentation, wound ulceration
First-line treatment
Cryotherapy	50 to 76	NA	Useful on small lesions; easy to perform	Review of multiple case studies9
			May cause hypopigmentation, pain
Intralesional corticosteroid injection (triamcinolone acetonide 10 to 40 mg per mL at six-week intervals)	50 to 100	9 to 50	Inexpensive; available in family physician's office	Review of multiple case studies9
			Requires multiple injections
			May cause discomfort, skin atrophy, telangiectasia
Silicone elastomer sheeting	50 to 100	NA	Multiple preparations available; tolerated by children	Review of multiple case studies8
			Expensive; poor study designs
Pressure dressing (24 to 30 mm Hg) worn for six to 12 months	90 to 100	NA	Inexpensive	Review of multiple case studies9
			Difficult schedule; poor adherence
Second-line and alternative treatment
Surgical excision	NA	50 to 100	Z-plasty option for burns	Review of multiple case studies9
			Immediate postsurgical treatment needed to prevent regrowth
Combined cryotherapy and intralesional corticosteroid injection	84	NA	See benefits of individual treatments	Case study1
			May cause hypopigmentation
“Triple keloid therapy” (surgery, corticosteroids, and silicone sheeting)	88 at 13 months	12.5 at 13 months	Tedious; time intensive; expensive	Case study14
Pulsed dye laser	NA	NA	Specialist referral needed; expensive; variable results depending on trial (controversial)	Case studies15,16
Verapamil 2.5 mg per mL intralesional injection combined with perilesional excision and silicone sheeting	54 at 18 months	NA	Repeated injections; limited experience	Clinical trial17
			May cause discomfort
Fluorouracil 50 mg per mL intralesional injection two to three times per week	88	0	Effective	Review of multiple case studies7
			May cause hyperpigmentation, wound ulceration
Bleomycin tattooing 1.5 IU per mL	927	NA	Effective	Review7
	8819		May cause pulmonary fibrosis, cutaneous reactions	Case study18
				Control trial19
Postsurgical interferon alfa-2b 1.5 million IU intralesional injection twice daily for four days	30 to 50	8 to 19	Expensive	Review of multiple case studies9
			May cause pruritus, altered pigmentation, pain
Radiation therapy alone	56 (mean)	NA	Local growth inhibition	Review of multiple case studies9
			May cause cancer, hyperpigmentation, paresthesias
Postsurgical radiation therapy	76	NA	Local growth inhibition	Review of multiple case studies9,20
			May cause cancer
Onion extract topical gels (e.g., Mederma)	NA	NA	Limited effect alone, better in combination with silicone sheeting	Prospective case study21