Effect of lidocaine tape on pain during intralesional injection of triamcinolone acetonide for the treatment of keloid

Abstract

Background: Because intralesional injection of triamcinolone acetonide (TA), a widely used for the treatment of keloid, is painful, many patients discontinue treatment. We evaluated the effects of pretreatment with topical 60% lidocaine tape on the pain and tolerability of intralesional TA treatment in patients with keloid.

Methods: The subjects were 42 patients with keloid who had been treated with intralesional injection of TA but had discontinued treatment owing to intolerable pain. All patients were pretreated with 60% lidocaine tape placed on the keloids for more than 120 minutes before intralesional injection of TA. Patients assessed pain with a 100-mm visual analog scale (VAS) with 0 mm for "no pain" and 100 mm for "worst possible pain." Pain was assessed with the VAS immediately after TA injection. Finally, the patients assessed the tolerability of this treatment.

Results: The mean VAS score during intralesional TA injection therapy without pretreatment with lidocaine tape was 82.6 +/- 14.4 mm. In contrast, the mean VAS score during intralesional TA injection therapy in the same patients after pretreatment with lidocaine tape was 18.9 +/- 11.3 mm, which was significantly lower (P<.0.05), and 30 (71.4%) of the patients tolerated this therapy well.

Conclusion: Pretreatment with 60% lidocaine tape significantly reduces the pain associated with intralesional injection of TA. This approach increases patient comfort and should enable patients to continue the treatment.