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

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®

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

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.

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.

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.

the first question that needs to be answered is are you showing signs of contraction and entropion?if not then maybe you don't need these injections. That being said these two medications mixed together are synergistic or work together and many of us use this particular combination frequently because they give us a little bit better result than either of them alone.  be sure to discuss this thoroughly with your surgeon and even get a second opinion with regards to the necessity of this in your case.

Chase Lay, MD

double board certified facial plastic surgeon