Proof of Kenalog Injection for Scar Tissue?

[David1991]

I have seen a lot of talk over the years about kenalog injections for breaking up scar tissue. However, all of this has been from people online. I have yet to see a single study purporting that this is a use of Kenlog.

Additionally, I have seen many warn that kenalog injections that miss the scar tissue can cause a divot in the area, necrosing the fat and muscle in that area.

However, everything I have come across scientifically has shown that kenalog is specifically meant for intramuscular use and on drugs.com it also specifically says that it is NOT meant for intradermal use


So can someone provide me with some proof that Kenalog is actually meant for scar tissue at all? That it has even been shown to actually reduce scar tissue in that area? And that there is any proof of it necrosing muscle tissue if a bad injection is done, when it fact it is meant for an intramuscular injection? 



Thank you

[David1991]

Anyone?

[Dr. Elliot Jacobs]

Kenalog has been used quite successfully, off-label, by dermatologists and plastic surgeons for scar tissue for over 50 years.  It works, but since it is quite powerful, it must be injected by an expert.  The dose, quantity, method of injection, doctor's skills, etc all will affect the final result.

Dr Jacobs

[DrPensler]

Your comment that   
 "I have seen a lot of talk over the years about kenalog injections for breaking up scar tissue. However, all of this has been from people online. I have yet to see a single study purporting that this is a use of Kenlog." indicate to me the following
1) you have minimal to no medical knowledge
2) you are a bit of a know it all
3) you are somewhat angry

If a patient on mine wanted some additional information on kenalog and its interaction with scar after we had discussed its use
I would recommend they go to Pubmed and run a search of kenalog and scar.

[David1991]

Your comment that   
 "I have seen a lot of talk over the years about kenalog injections for breaking up scar tissue. However, all of this has been from people online. I have yet to see a single study purporting that this is a use of Kenlog." indicate to me the following
1) you have minimal to no medical knowledge
2) you are a bit of a know it all
3) you are somewhat angry

If a patient on mine wanted some additional information on kenalog and its interaction with scar after we had discussed its use
I would recommend they go to Pubmed and run a search of kenalog and scar.

Ironic considering I'm close to getting my DDS MD degree. I would sure like to know it all, unfortunately we are all far from that.

The 20 pages about Kenalog do not even mention scar tissue or fibrous tissue.

I came across 1 abstract on Triamcinolone related to hypertrophic scar tissue but that was it.

Kenalog has been used quite successfully, off-label, by dermatologists and plastic surgeons for scar tissue for over 50 years.  It works, but since it is quite powerful, it must be injected by an expert.  The dose, quantity, method of injection, doctor's skills, etc all will affect the final result.

Dr Jacobs

Thanks for the helpful response Dr. Jacobs. I'm not saying Kenalog doesn't work for reducing scar tissue, I just found it interesting that none of the recommended uses for it had to do with reducing internal scar tissue. AND the fact that most labels specifically say it is not meant for intradermal use and is specifically meant for intramuscular use (when plastic surgeons warn that it must not enter the muscle or it will cause necrosis).

[DrPensler]

Perhaps you should read some of your texts then if you claim to be getting an MD .This is work from the sixties and seventies and is commonly available in surgery  and pharmacology texts but it has been updated and enhanced over the last 50 years.
Pharmacologic treatment of lesions characterized by excessive collagen production ( scar ) has been historically directed towards either decreasing protein production ( specifically ,collagen production ) or enhancing collagen turnover by rendering the collagen molecule more soluble or more susceptible to enzymatic degradation. Steroids act both by decreasing collagen synthesis but interestingly also enhance collagenase activity.

[David1991]

Perhaps you should read some of your texts then if you claim to be getting an MD .This is work from the sixties and seventies and is commonly available in surgery  and pharmacology texts but it has been updated and enhanced over the last 50 years.
Pharmacologic treatment of lesions characterized by excessive collagen production ( scar ) has been historically directed towards either decreasing protein production ( specifically ,collagen production ) or enhancing collagen turnover by rendering the collagen molecule more soluble or more susceptible to enzymatic degradation. Steroids act both by decreasing collagen synthesis but interestingly also enhance collagenase activity.

I find the first part surprisingly considering such information did not come up at all in the entire Lexicomp database on Kenalog. Having said that, I certainly do not know the content of all related texts so maybe it is in fact in there, somewhere.

I agree with those actions carried out by some corticosteroids, but found it odd that all sources directing the use of kenalog specifically said not to inject in intradermally and to specifically inject it intramuscularly. The plastic surgeons I have spoken to have been adamant about the fact that it would be very bad to have the kenalog enter any area that is not the scar tissue due to it causing discoloration and necrosis of the muscle and fat there. It seems unlikely that this side effect would actually occur when it is meant for that location specifically.

All in all, was just looking for some more scientific evidence for what I have heard about kenalog up to this point. Seems like some is out there while other specifics are missing.

[David1991]

Have you doctors found that in the weeks following kenalog injections massaging the area is even more important (to "break up the scar tissue" and the like), or have you found it to be somewhat irrelevant whether or not someone massages, as far as the efficacy of the kenalog in reducing scar tissue goes?



Thanks