Ten Years’ Clinical Experience with Intralesional Cryosurgery and Adjunctive Therapies for Keloid Management in Hong Kong

BACKGROUND: Surgical excision followed by radiotherapy remains the standard for keloid treatment but is often limited by accessibility and recurrence. Intralesional cryosurgery offers a minimally invasive alternative by directly targeting keloid tissue. Over the past decade, I have applied intralesional cryosurgery combined with adjunctive triamcinolone/FU injections and laser/light therapy in clinical practice to optimise outcomes and reduce recurrence.

METHODS: This presentation summarises my clinical experience treating patients with keloids using intralesional cryosurgery. The procedure involves inserting a cryoprobe directly into the keloid base to induce controlled freezing and necrosis. Adjunctive triamcinolone/5FU injections are administered post-procedure to reduce recurrence, followed by laser/light therapy sessions to improve scar texture and pigmentation. Treatment outcomes are illustrated through representative case examples and longitudinal clinical observations.

RESULTS: Over ten years, patients treated with this combined approach demonstrated consistent reduction in keloid volume and symptomatic relief, with improved scar pliability and pigmentation. Recurrence rates appeared lower compared to historical outcomes with excision alone. The minimally invasive nature of intralesional cryosurgery resulted in favourable tolerability and patient satisfaction.

CONCLUSION: Intralesional cryosurgery combined with triamcinolone/5FU injection and laser/light therapy represents a practical, effective treatment strategy for keloids, especially in settings where expertise of surgery and radiotherapy are limited. Sharing this decade-long clinical experience aims to provide valuable insights and encourage wider adoption of this less invasive approach. Further prospective studies are warranted to validate and refine treatment protocols.