Evidence map›Paper›PMID 40010838›Full record

ArticleBMJ open2025

Scoping review for pain mitigation during intralesional injections of corticosteroid for hypertrophic scar and keloid treatment.

Jeffrey Mardhiah, Ahmad Sukari Halim, Sophia Heng, Ainna Qistina Saipolamin

Abstract readScoping Review
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Neomycin sulfate and triamcinolone acetonide suspended ointment designed for transdermal delivery: formulation and in vitro evaluation.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Jeffrey MardhiahReconstructive Sciences Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.ORCID http://orcid.org/0000-0002-7691-7136
Ahmad Sukari HalimReconstructive Sciences Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia ashalim@usm.my.ORCID http://orcid.org/0000-0002-7691-7136
Sophia HengReconstructive Sciences Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Ainna Qistina SaipolaminReconstructive Sciences Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntralesional corticosteroid injection (ILCSI) has been proven to successfully treat hypertrophic scars (HTSs) and keloids and attain remission in 50% of keloids. Pain is a significant problem with ILCSI, which can affect treatment compliance and effectiveness. To date, many techniques involving ILCSI have been described and used to achieve scar treatment while reducing side effects. The injection technique remains the most widely available method in many healthcare centres.

objectiveThis scoping review explores strategies for alleviating pain while administering ILCSIs for hypertrophic scarring and keloid management. ILCSI is a second-line treatment for HTSs and a first-line treatment for keloids. ELIGIBILITY CRITERIA: This scoping review included studies where HTSs and keloids were treated with ILCSI and considered diverse demographics and injection methods. This review excludes other methods of corticosteroid drug delivery where injection is not involved and where the pain assessed is unrelated to injection or infiltration of the scar. SOURCES OF EVIDENCE: This review systematically searched critical databases from inception to December 2023, including ScienceDirect, PubMed and Web of Science, and handpicked articles traced from available review papers. Only English-language publications focused on pain management during ILCSIs for HTSs and keloids were included. All levels of scientific evidence were considered. An in-depth evaluation of the injection technique, type of analgesia or anaesthesia administered, effectiveness of pain management and overall treatment outcomes was conducted. CHARTING

methodsCitations were compiled in an Excel spreadsheet, with three authors screening the titles and abstracts based on inclusion criteria. Decisions were finalised collaboratively, exclusions were documented and results were presented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram.

results16 prospective studies, 2 retrospective studies, 1 case study and 15 journal articles were included. These studies examined ILCSI for hypertrophic scarring and keloid treatment. No differences in pain intensity between HTSs and keloids were reported. 11 studies systematically explored pain reduction methods such as topical analgesia, cryoanaesthesia, mixing triamcinolone acetonide with local analgesics, slow infiltration techniques, vibration analgesia and needle-free injectors.

conclusionPain can significantly impact patient compliance and treatment outcomes. This review offers a foundational reference for healthcare providers and researchers in the field of scar management, providing insights into current practices and highlighting areas for future research and development.

Indexed as

Adrenal Cortex HormonesCicatrix, HypertrophicKeloidPainPain ManagementHumansInjections, IntralesionalAdrenal Cortex HormonesPaediatric plastic & reconstructive surgeryPain managementSurgical pathology

Identifiers

PMID40010838
PMCPMC11865806

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.