What It Is

Defining 5-FU Scar Injection

→ 5-FU (5-Fluorouracil) scar injection is a medical treatment where the drug 5-fluorouracil, an anti-cancer medication, is injected directly into scar tissue.

→ In dermatology, 5-FU is not used for cancer but as a scar-modifying agent, especially for keloids and hypertrophic scars.

→ It works by disrupting the abnormal fibroblast activity that produces excess collagen, which is responsible for raised and thickened scars.

Key Characteristics

• A localized injection directly into the scar
• Often combined with corticosteroids for stronger effect
• Helps flatten raised scars and reduce redness and discomfort
• Considered especially effective for stubborn scars that don’t respond well to steroids alone

Why It’s Done

Main Reasons for Treatment

➡ Scar Flattening – To reduce the thickness and height of hypertrophic or keloid scars.

➡ Symptom Relief – Helps decrease itching, burning, and tenderness in problematic scars.

➡ Improved Appearance – Enhances cosmetic outcome by softening and lightening scars.

➡ Alternative to Steroid-Only Therapy – For patients who have limited results or side effects from intralesional steroids.

➡ Combination Therapy – Works well when used alongside laser treatment, cryotherapy, or radiation therapy.

Alternatives

Non-Medical Options

• Silicone Gel or Sheets → Helps with early-stage scars but less effective for severe ones.
• Scar Massage and Creams → Useful for fresh scars, though limited effect on long-term raised scars.

Medical Alternatives

→ Instead of 5-FU, patients may consider:

• Intralesional Steroid Injections (e.g., triamcinolone acetonide)
• Cryotherapy to freeze and shrink scar tissue
• Laser Therapy to reduce redness and improve texture
• Radiation Therapy after surgical excision for stubborn keloids
• Microneedling with RF to remodel collagen in thickened scars

Preparation

Before Treatment

➡ Dermatology Evaluation – The scar is assessed for size, thickness, and severity.

➡ Medical History Review – Patients must inform the doctor about previous treatments, medication use, and health conditions.

➡ Skin Cleaning – The area will be disinfected before injection.

➡ Pain Management – Topical anesthetic cream or local anesthetic may be applied, as 5-FU injections can be more painful than steroid-only injections.

➡ Expectation Setting – Results require multiple sessions; patients should prepare for gradual improvement rather than instant results.

How It’s Done

The Injection Procedure

Step 1: Cleansing
→ The scarred area is sterilized with antiseptic solution.

Step 2: Preparation of 5-FU Solution
→ 5-FU may be injected alone or mixed with corticosteroids (triamcinolone) to enhance effectiveness and reduce pain.

Step 3: Injection
→ A fine needle is used to inject the drug directly into the scar tissue.

• The injection targets fibroblasts, reducing collagen overproduction.
• Multiple small injections may be placed across the scar for even distribution.

Step 4: Post-Injection Care
→ Ice packs may be applied to reduce pain and swelling.
→ Patients can return to normal activities immediately.

Treatment Course

• Sessions usually repeated every 3–4 weeks
• Most patients require 4–8 sessions for visible results
• Combination with laser, cryotherapy, or silicone dressings often provides the best outcomes

Recovery

Immediate Recovery

• Pain or Stinging → Slight discomfort is common due to 5-FU’s irritation effect.
• Redness and Swelling → Temporary and usually resolves within a few days.
• Tenderness → May persist for 1–2 days.

Long-Term Recovery

→ Over time, scars begin to flatten, soften, and lighten in color.

→ Results are gradual but often noticeable after several sessions.

→ Patients are advised to use sun protection, moisturizing gels, and silicone dressings to support healing.

Complications

Possible Risks

• Pain and Burning Sensation → More common compared to steroid injections.
• Skin Ulceration → Rare but may occur if the injection is too strong or frequent.
• Hyperpigmentation or Hypopigmentation → Changes in skin color, especially in darker skin tones.
• Infection → Minimal but possible if injection site is not properly cared for.
• Allergic Reaction → Rare but possible; requires immediate medical attention.

Treatment Options in Korea

Advanced Dermatology Expertise

South Korea has developed highly effective scar management protocols, and 5-FU injections are an important part of this approach.

Why Korea is a Leader in 5-FU Scar Care

➡ Combination Therapy Focus – Korean clinics often mix 5-FU with steroids or lasers for superior results.
➡ Precision Injection Techniques – Performed by dermatologists with extensive experience in scar management.
➡ Patient-Centered Programs – Clinics provide structured treatment courses with follow-up care.
➡ Modern Facilities – Korean dermatology clinics are equipped with advanced tools to monitor scar progression.

Popular Approaches in Korea

• 5-FU + Corticosteroid Injections → Most common and effective method for flattening keloid and hypertrophic scars.
• 5-FU + Laser Therapy → Reduces redness and improves overall texture of the scar.
• 5-FU + Cryotherapy → Effective for stubborn keloids by combining freezing and fibroblast inhibition.
• Post-Surgical Use → After scar revision surgery, 5-FU injections help prevent recurrence.

Patient Experience in Korea

• The procedure is quick, outpatient-based, and minimally invasive.
• Patients may feel a stronger stinging sensation than with regular steroid injections.
• Clinics provide pain management strategies, including numbing creams and cooling devices.
• Follow-up care includes scar gels, silicone patches, and strict sun protection guidance.

Conclusion

5-FU scar injection in Korea is a powerful treatment option for patients with stubborn hypertrophic scars or keloids. By directly targeting fibroblast overactivity, it helps flatten scars, relieve discomfort, and improve cosmetic appearance.

Korean dermatologists are leaders in combining 5-FU injections with steroids, lasers, or cryotherapy, ensuring results that are both medically effective and cosmetically satisfying. For patients seeking advanced care, Korea provides a comprehensive, reliable, and patient-focused approach to scar treatment.