Combined modalities in the management of hypertrophic scars and keloids.

A surgeon has many treatment options available during the longterm management of a patient with keloids or hypertrophic scars. The thoughtful combination of multiple modalities in a staged manner may produce a more favorable result than the application of a single technique. A case is presented which illustrates the concept of preliminary treatment with cryotherapy and low dose intralesional triamcinolone followed at interval by surgical excision.