Safety and Efficacy of Intralesional Steroid versus Intralesional Verapamil in Patients with Keloid and Hypertrophic Scars

Background: Scar formation is a normal wound-healing process, but prolonged inflammation can lead to abnormal scarring such as hypertrophic scars and keloids, which are unique to humans. While intralesional steroids (ILSs) are the standard treatment, intralesional verapamil remains underexplored despite some promising results. Purpose: The purpose of this study was to compare the safety and efficacy of intralesional corticosteroids versus intralesional verapamil in keloid and hypertrophic scars. Methods: A randomized, parallel-group comparative study was conducted in the outpatient department of dermatology in a tertiary hospital. Fifty patients, aged over 18 years with keloid or hypertrophic scars, were randomly assigned to two groups: Group A ( n = 25) received corticosteroids, and Group B ( n = 25) received verapamil. Scar outcomes were assessed using the Vancouver Scar Scale (VSS), across five visits. Safety was monitored through adverse event documentation. Data were compiled in Excel and analyzed with SPSS 24.0. Quantitative data were expressed as means, standard deviations, and categorical data as percentages with visual aids. Results: The VSS scores consistently decreased in both the verapamil and ILS groups at all visits. Significant improvements in scar height, vascularity, and pliability were observed starting from the second ( P < 0.05). However, pigmentation showed no change in the first two visits for both the groups. The incidence of adverse effects was lower with verapamil. Conclusion: Both corticosteroids and verapamil demonstrated a reduction in scar height, pliability, and vascularity over time. However, the rate of improvement was more pronounced with triamcinolone. Verapamil presents a viable alternative with more favorable safety profile.