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Systematic review shows intralesional vitamin D reduces steroid risks for keloid patientsTriamcinolone works better for keloids, but vitamin D spares skin damage

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Key Takeaway
Vitamin D offers a safer alternative to triamcinolone acetonide for keloids, reducing risks of atrophy and pigmentation while maintaining comparable treatment options.

This systematic review and meta-analysis evaluated randomized controlled trials comparing intralesional vitamin D against intralesional triamcinolone acetonide for treating keloids. The analysis pooled data from four trials involving patients with keloid scars to assess efficacy and safety outcomes.

results indicated that triamcinolone acetonide demonstrated superior efficacy regarding overall scar severity and lesion flattening. Statistical measures confirmed these differences were significant, with triamcinolone acetonide showing a mean difference of -9.72 for scar severity and a relative risk of 0.68 for lesion flattening.

Conversely, the vitamin D group exhibited a more favorable safety profile. Patients receiving vitamin D experienced significantly lower risks of skin atrophy and pigmentation changes compared to those treated with triamcinolone acetonide. While triamcinolone acetonide remains effective for scar reduction, the safety advantages of vitamin D may make it a viable alternative for specific patient populations.

The findings suggest that clinicians might consider vitamin D for patients concerned about adverse effects or those with lesions in cosmetically sensitive areas. Given the limited evidence base, these results should be interpreted cautiously while acknowledging the potential benefits of reducing steroid-related complications.

Keloids are thick, raised scars that often hurt and change skin color. Doctors usually inject triamcinolone acetonide to shrink them. But this treatment can thin the skin or cause discoloration. A new analysis of four trials looked at adding vitamin D to the mix. The results show a clear trade-off between how well the scar looks and how safe the skin stays.

Triamcinolone acetonide was far more effective at improving scar severity and flattening the lesion. Patients receiving this steroid saw better results on standard medical scales. However, vitamin D injections were linked to a much lower risk of skin thinning and unwanted color changes. This safety benefit matters for people worried about side effects or scars in visible areas.

The study combined data from four trials to reach these conclusions. While the findings suggest vitamin D is safer for the skin, the overall evidence base remains limited. Doctors should weigh the strong benefits of the steroid against the potential for skin damage when choosing a treatment plan.

What this means for you:
Triamcinolone works better for keloids, but vitamin D reduces skin thinning and color changes.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJun 2026
View Original Abstract ↓
Intralesional triamcinolone acetonide (TAC) remains the standard nonsurgical treatment for keloids but is limited by steroid-related adverse effects. Intralesional vitamin D has recently emerged as a potential alternative. This meta-analysis evaluated the comparative efficacy and safety of vitamin D versus TAC in keloid management. A systematic search of PubMed, Embase, and the Cochrane library identified randomized controlled trials comparing these treatments. The primary outcome was scar improvement assessed using validated scales, while secondary outcomes included lesion flattening and treatment-related adverse events. Four trials were included. TAC demonstrated superior efficacy in improving scar severity (MD = −9.72; 95% CI -17.41 to −2.02; p = 0.013) and lesion flattening (RR = 0.68; 95% CI 0.48 to 0.96; p = 0.028). Vitamin D was associated with significantly lower risks of pigmentation changes (RR = 0.23; 95% CI 0.07 to 0.78; p = 0.018) and skin atrophy (RR = 0.51; 95% CI 0.32 to 0.82; p = 0.006), with no significant differences in pain, erythema, telangiectasia, or blister formation. While TAC appeared more effective for scar regression and lesion flattening, vitamin D was associated with a more favorable safety profile, particularly regarding skin atrophy and dyspigmentation. Vitamin D may be considered in selected patients who are particularly concerned about steroid-related adverse effects or lesions located in cosmetically sensitive areas, although these findings should be interpreted cautiously given the limited evidence base.
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