Clinical Efficacy of Local Injection of Compound Betamethasone Versus Triamcinolone Acetonide in the Treatment of Hypertrophic Scars: A Retrospective Analysis of 126 Patients

BACKGROUND: Hypertrophic scars (HTS) are common complications of wound healing characterized by excessive fibroblast proliferation and collagen deposition. HTS causes local elevation, pruritus, and pain, significantly impacting aesthetics and quality of life. While triamcinolone acetonide (TA) and compound betamethasone (CB) are standard treatments, direct comparative studies regarding their efficacy and recurrence rates remain limited. OBJECTIVE: To evaluate the clinical efficacy, safety, and recurrence rate over 6 months of local injection of TA and CB monotherapy in the treatment of HTS. METHODS: We retrospectively analyzed 126 patients with HTS who received intralesional injection therapy at our hospital between December 2021 and December 2024. Patients were divided into the TA group (n = 63) and the CB group (n = 63) based on the injected drug. All patients were observed during treatment and followed for at least 6 months to monitor adverse reactions and recurrence. Scar assessment was performed using the Vancouver Scar Scale (VSS), combined with high-frequency ultrasonography to measure scar thickness changes. Clinical efficacy was evaluated based on the percentage reduction in VSS scores. RESULTS: Baseline characteristics were not significantly different between the two groups. Both CB and TA significantly reduced VSS scores and ultrasonographically measured scar thickness in patients with HTS; however, the CB group exhibited greater reductions in both VSS scores and scar thickness compared with the TA group. Evaluation of clinical efficacy revealed a total effective rate of 93.65% in the CB group versus 80.95% in the TA group. The incidence of adverse reactions was similar between the two groups, primarily consisting of local skin atrophy, pigmentation changes, and telangiectasia. The 6-month recurrence rate was significantly lower for CB (3.17%) than for TA (15.87%, p = 0.015). CONCLUSION: Both CB and TA intralesional injections are effective in improving VSS scores, reducing scar thickness, and achieving high clinical efficacy rates in patients with HTS. However, CB demonstrates superior therapeutic outcomes and a significantly lower recurrence rate compared with TA, supporting its wider clinical application.