Intralesional
steroid injections are the standard treatment for
hypertrophic scars and
keloids. The procedure is, however, quite painful and is unpopular with patients because of this. Topical application of
anesthetic creams, such as
Ametop gel (
tetracaine) and
EMLA cream (
lidocaine and
prilocaine), has limited efficacy because of poor
drug penetration. The onset of the
analgesic effect is also slow, which means that the use of
topical anesthetics is time-consuming in clinical practice.We hypothesized that a commercially available cryotip could be used to provide fast-acting topical
cryoanesthesia that would reduce the
pain associated with
steroid injections.Thirty patients with
hypertrophic scars or
keloids were enrolled in the study.
Scars were injected with the
steroid,
triamcinolone acetonide, with or without prior application of the cryotip (-10 °C) for 15 seconds. The degree of
pain was evaluated in each case using the visual analogue scale (VAS) and the verbal descriptor scale (VDS), together with any side-effects caused by application of the cryotip.The VAS
pain scores showed a statistically significant (P < .01) difference between the pretreated and the control
scars (
pain scores 7.87 ± 1.31 and 2.7 ± 1.37, respectively). The VDS
pain scores also showed a statistically significant (P < .01) difference between the pretreated and the control
scars. And its average scores were 7.89 ± 0.32 and 2.68 ± 0.25, respectively.Application of the cryotip before injection could provide a rapid and effective means of reducing the
pain associated with
steroid injections. Painless would result in better
therapeutic effect.