triamcinolone acetonide + lidocaine + epinephrine

This intervention is a combination of the synthetic corticosteroid triamcinolone acetonide and the local anesthetic lidocaine (formulated with epinephrine), investigated by Vanderbilt University Medical Center. It was evaluated in a randomized, double-blind clinical trial (NCT03630198) to determine if the addition of a local anesthetic could mitigate the procedural pain associated with intralesional corticosteroid injections for dermatological conditions such as alopecia areata, psoriasis, and keloids. Triamcinolone acetonide acts as a glucocorticoid receptor agonist to reduce inflammation, while lidocaine functions as a voltage-gated sodium channel blocker to provide anesthesia. Epinephrine is included to induce local vasoconstriction, prolonging the anesthetic effect. Interestingly, the study concluded that the addition of lidocaine with epinephrine actually increased injection pain compared to a saline control, likely due to the acidic pH of the anesthetic solution, leading researchers to suggest omitting the anesthetic to minimize patient discomfort.

Brand names

Kenalog-40Kenalog40Kenalog 40XylocaineXylocaine with Adrenaline

Other names

corticosteroid + lidocainetriamcinolone acetonide + lidocaineCorticosteroid with lidocaineIntralesional corticosteroid with lidocaine