Does 5-FU Have to Be Mixed with Kenalog to Be Effective?

Question

My understanding is that Kenalog (steroids) can cause tissue atrophy, while 5-FU does not have this risk. Most doctors combine the two. Do they need to be mixed to be effective? Or can 5-FU be used on it's own. What are the recommended doses? If it will help, I am seeking this treatment for internal eyelid scars from a trans. bleph that are 6 months old and prevent my eyelid from raising all the way up. Thank you in advance.

David C. Pearson, MD · Answer

5-fluorouracil can be quite effective all by itself. It often requires multiple sessions of treatment although a precise interval between sessions has not been established. Also, 5-FU is probably more effective when used very early in the wound healing timeline, but it can be effective months later such as in your case. There's little downside to trying 5-FU by itself, but mixing it with a small amount of Kenalog is fine, too, and may be better for older scars.

	All the best,

	--DCP

	Pearson Facial Plastic Surgery®

Stephen Weber MD, FACS · Answer

5-FU and Kenalog are often mixed and work very well. However, as you pointed out some people are susceptible to atrophy with even small amounts of steroid injection. 5-FU alone typically is effective without that risk of atrophy. It is worth a try to treat your scar as long as you've found a surgeon experienced with 5-FU injection. The other suggestions made by my colleagues are also helpful, massage at this time and possibly revision if you continue to have troubles. I hope this answers your question. 

	Stephen Weber MD, FACS

Mehryar (Ray) Taban, MD, FACS · Answer

5FU can be injected by itself and it works great for scars. Kenalog is mixed since steroid will decrease any inflammation that may be present or result from any drug injection.

Kenneth D. Steinsapir, MD · Answer

It is reasonable to try 5-FU this can provide some relief.  Steroids might provide more.  However, the steroids are also associated with fat atrophy.  Mechanical massage can also help stretch out the lower eyelid.  When these measures fail, the treatment is surgical reconstruction.

Matheson A. Harris, MD · Answer

Kenalog and 5-FU work together to reduce scarring, but both can have undesirable effects. At 6 months post op, you may not see a lot of change. If the eyelids are scarred and not elevating properly, we often have to release scar tissue on the inside of the eye and/or do some lower eyelid tightening to restore the position of the eyelid.  An evaluation with an oculoplastic surgeon would be a good idea as we are often called upon to fix eyelid retraction, no matter what may have caused it.

Does 5-FU Have to Be Mixed with Kenalog to Be Effective?

Answers (6)

Answer: At 6 months, you will need reconstructive surgery.

Answer: At 6 months, you will need reconstructive surgery.

Answer: Kenalog and 5-FU

Answer: Kenalog and 5-FU

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Does 5-FU Have to Be Mixed with Kenalog to Be Effective?

Answers (6)

Answer: At 6 months, you will need reconstructive surgery.

Answer: At 6 months, you will need reconstructive surgery.

Answer: Kenalog and 5-FU

Answer: Kenalog and 5-FU

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Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.