• Pu Wang, Luosha Gu, Hongsen Bi, Qifei Wang, and Zelian Qin.
• Department of Plastic Surgery, Peking University Third Hospital, Beijing, People's Republic of China.
• Aesthet Surg J. 2021 May 18; 41 (6): NP567-NP575.

BackgroundClinical treatment of hypertrophic scars (HSs) and keloids is often unsatisfactory. Intralesional injections of triamcinolone acetonide (TAC) and verapamil are widely used to treat HSs and keloids, but their efficacy and safety are controversial.ObjectivesThe aim of this study was to conduct a meta-analysis of the effectiveness and safety of verapamil and TAC in the treatment of HSs and keloids.MethodsEmbase, Google Scholar, and PubMed were searched for randomized controlled trials (RCTs) from inception to February 2020. RCTs that evaluated treatment effects with the Vancouver Scar Scale or reported adverse effects were included. The continuous data and the dichotomous variables were analyzed as mean difference (MD) and relative risk (RR), respectively.ResultsSeven RCTs (461 patients) were included. Compared with verapamil, TAC rapidly changed the ∆height (MD = 0.07; P < 0.05) and ∆pliability (MD = 0.23; P < 0.05) after the first session, but subsequent treatments resulted in no significant differences in the ∆height, ∆pigmentation, ∆vascularity, and ∆pliability. Although total adverse effects (RR = 0.42; P = 0.1) were not significantly different, in the subgroup analysis the incidence of telangiectasia (RR = 0.04; P < 0.05) and skin atrophy (RR = 0.10; P < 0.05), but not pain (RR = 1.27; P = 0.77), was significantly lower with verapamil than with TAC.ConclusionsVerapamil may be an effective substitute for TAC. Although total adverse effects did not change, the incidence of telangiectasia and skin atrophy was lower with verapamil than with TAC.Level Of Evidence: 4© 2020 The Aesthetic Society. Reprints and permission: journals.permissions@oup.com.

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