Abstract
BACKGROUND: Keloid treatment remains challenging due to high recurrence rates, particularly in patients with higher phototypes. This study aimed to assess the resolution, patient satisfaction, and recurrence rates in 79 keloids treated with a sequential non-surgical protocol combining long-term occlusion with hydrocolloid dressings, monthly injections of triamcinolone and 5-fluorouracil (5-FU), and intense pulsed light therapy. This approach is expected to lower recurrence, improve resolution, and increase patient satisfaction compared to traditional treatments. METHODS: This longitudinal observational study included 79 keloids in 55 patients with Fitzpatrick phototypes III or higher. Data were collected retrospectively from medical records and clinical appointments. Patients were followed for 19-123 months after completing treatment. Outcomes evaluated included keloid resolution, patient satisfaction, and recurrence rates. RESULTS: The patients had a mean age of 39 years and underwent treatment for a median of 10 months. Pain was reported in 8.9% of cases, and only one recurrence (1.3%) occurred five years post-treatment. Complete resolution was achieved in 82.3% of keloids, and 94.9% of patients reported maximum satisfaction. CONCLUSIONS: The sequential non-surgical approach evaluated in this study demonstrated low recurrence and high satisfaction rates. Thus, it may represent a promising treatment option for keloid patients with higher phototypes.