Steroid Treatments for Keloid Painful?

Kenalog injections, or Triamcinolone Injections, are available in two common strengths and are injected intralesionally into keloid and hypertrophic scars. Patients with uncomfortable and painful keloids often complain of pain at the time of incision. However, the kenalog is generally therapeutic and improves scar thickness and quality.
I give my patients numbing medication in a topical cream prior to injection. This usually satisfies the requirement for pain control.

Though steroid injections can be quite painful, the pain can be amerliorated by using either a cooling device like a Zimmer or cryothera[y. Cryotherapy also is helpful in treating the keloid. There is the caveat, however, that if the cryo is done too long, hypopigmentation can result.