Combination of fractional carbon dioxide laser and topical triamcinolone vs intralesional triamcinolone for keloid treatment: A randomised clinical trial

Abstract

To compare the therapeutic effect of fractional carbon dioxide (CO 2 ) laser + topical triamcinolone (TA) with intralesional TA on keloids. Twenty-two participants were randomised into two groups: group A, treated with fractional CO 2 laser + topical TA, and group B, treated with intralesional TA. The interventions were performed at every 4-week interval until the keloids were resolved or at the completion of 1 year. At each session, the scar volume, Vancouver Scar Scale (VSS) were assessed. Recurrence was observed for 1 year. The mean scar volumes and VSS scores were not significantly different between the two groups. After 1 year, the scar volume change in group B was greater than group A (86.5% vs 59.1%, P-value = .016). The mean VSS scores were significantly decreased in group A (8.0 ± 1.5 to 4.8 ± 1.6, P-value <.001) and group B (8.4 ± 0.8 to 4.8 ± 1.6, P-value <.001). The keloids were completely resolved in 63.6% and 72.7% of the patients, and recurrence was observed in 9.1% and 18.2% of the patients in groups A and B, respectively. The combination of fractional CO 2 laser with topical TA was an alternative option for the treatment of keloids.

Application of fractional carbon dioxide laser monotherapy in keloids: A meta‐analysis

“…22,23 In recent years, with the advancement of optoelectronic technology and a public focus on aesthetics, laser therapy has been widely used in clinical practice because of its advantages such as less trauma, faster recovery, and significant improvement in scar appearance. [24][25][26] Because of its low efficiency and high recurrence 95% CI: −1.17 to −0.63) were significantly improved after fractional CO 2 laser treatment for keloids, although vascularity did not significantly change. However, there was significant heterogeneity (I 2 = 98.0%, p = 0.000) in the analysis of vascularity, challenging the confidence in this aspect of our results.…”

“…Although the summary results of this study show that fractional CO 2 laser monotherapy can effectively treat keloids, and more studies have revealed that fractional CO 2 laser combined therapy can significantly improve the efficacy of the treatment of keloids. Tawaranurak et al 24 discovered that the combination of fractional CO 2 laser treatment and topical triamcinolone resulted in a more significant reduction in scar volume compared to using topical triamcinolone alone for treating keloids (86.5% vs. 59.1%, p-value = 0.016). In addition, Sabry et al s study revealed that fractional CO 2 laser combined with 5-fluorouracil or verapamil hydrochloride can significantly reduce VSS.…”

“…In recent years, with the advancement of optoelectronic technology and a public focus on aesthetics, laser therapy has been widely used in clinical practice because of its advantages such as less trauma, faster recovery, and significant improvement in scar appearance 24–26 . Because of its low efficiency and high recurrence rates, the conventional CO 2 laser has been supplanted by the fractional CO 2 laser.…”

“…There are 12 items, each with a mean score of 0-2, for a total of 24 points. The studies are categorized by score as "moderate quality" (9)(10)(11)(12)(13)(14)(15)(16) and "high quality" (17)(18)(19)(20)(21)(22)(23)(24). The metaanalysis was performed in accordance with the relevant items in the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) statement.…”

The application of corticosteroids for pathological scar prevention and treatment: current review and update

“…However, the 1-year follow-up results revealed recurrence rates of 9.1 and 18.2%, respectively. These results indicate that the combination of fractional CO 2 lasers and topical TAC may be an alternative treatment for keloids [ 75 ]. In addition, intralesional injections of TAC and desoxymethasone ointments were administered after uniform ablation using fractional Er:YAG lasers.…”