Clinical Report: Comparative Efficacy of Intralesional Vitamin D and TAC in Keloids

Overview

This systematic review and meta-analysis evaluated the efficacy and safety of intralesional vitamin D compared to triamcinolone acetonide (TAC) in keloid treatment. TAC showed superior efficacy in scar improvement and lesion flattening, while vitamin D demonstrated a more favorable safety profile with lower risks of pigmentation changes and skin atrophy.

Background

Keloids are challenging to treat and often require effective management strategies to reduce scar severity and improve patient outcomes. Intralesional triamcinolone acetonide (TAC) is the standard nonsurgical treatment but is associated with potential steroid-related adverse effects. The emergence of intralesional vitamin D as an alternative treatment option necessitates a comparative evaluation of its efficacy and safety.

Data Highlights

Key Findings

• TAC demonstrated superior efficacy in improving scar severity and lesion flattening compared to vitamin D.
• Vitamin D was associated with significantly lower risks of pigmentation changes and skin atrophy.
• No significant differences were observed between treatments regarding pain, erythema, telangiectasia, or blister formation.
• Vitamin D may be considered for patients concerned about steroid-related adverse effects.
• The findings are based on four randomized controlled trials.

Clinical Implications

Clinicians should consider the efficacy of TAC in keloid treatment while being mindful of its adverse effects. Vitamin D may be a suitable alternative for patients who prioritize a favorable safety profile, particularly in cosmetically sensitive areas.

Conclusion

While TAC remains the more effective option for scar regression and lesion flattening, vitamin D offers a safer alternative for specific patient populations. Further research is warranted to strengthen the evidence base for these findings.

Related Resources & Content

1. Frontiers, 2026 -- Intralesional Vitamin D versus Triamcinolone Acetonide for the Treatment of Keloids
2. MDPI, 2026 -- Clinical and Therapeutic Predictors of Keloid Recurrence: Outcomes in a European Cohort of 206 Patients
3. Merck Manual, 2025 -- Keloids
4. Retinal Physician — Steroids in Diabetic Macular Edema
5. Retinal Physician — Steroid Implants in the Diabetic Macular Edema Treatment Paradigm
6. Contact Lens Spectrum — Treatment Plan
7. Retinal Physician — Peer-Reviewed: Intraocular Pressure Changes After Removal of Sub-Tenon’s Triamcinolone Acetonide Depot
8. Steroids in Diabetic Macular Edema
9. Steroid Implants in the Diabetic Macular Edema Treatment Paradigm
10. Treatment Plan
11. Clinical and Therapeutic Predictors of Keloid Recurrence: Outcomes in a European Cohort of 206 Patients | MDPI
12. Keloids - Dermatology - Merck Manual Professional Edition
13. Frontiers | Intralesional Vitamin D versus Triamcinolone Acetonide for the Treatment of Keloids: A Systematic Review and Meta-analysis of Randomized Controlled Trials
14. Comparison of efficacy of intralesional vitamin D3 versus intralesional triamcinolone acetonide in keloid – A randomized double-blinded non-inferiority study - JCAS
15. Comparative efficacy of intralesional therapies for keloid scars: a network meta-analysis - PMC
16. Frontiers | Efficacy and safety of glucocorticoid-based therapies in the management of keloids: a systematic review and meta-analysis of clinical outcomes