In-situ irradiation of keloid scars with Nd:YAG laser

Abstract

In-situ coagulation of keloid with Nd:YAG laser irradiation was carried out in in a cohort study of 17 patients, each with one keloid scar situated on either the sternum (six), abdomen (seven), shoulder (two), hip (one), or ear lobe (one). The duration of scarring was three to 17 years and size varied from 3-8 cm long. One to two doses of laser irradiation was required for complete coagulation. At three months, 10 (58.8%) keloids had completely healed; but in seven (41.1%), 25-50% of residual keloid persisted. Intralesional triamcinolone injection, once in four patients and twice in three patients, produced complete resolution in all seven patients. At 18 months to five years follow-up, 14 patients remain keloid-free but in three keloid recurred and was re-treated with laser coagulation with complete resolution. The treatment was carried out as an outpatient procedure under local anaesthesia. There were no complications. The results of this initial study suggest that Nd:YAG laser irradiation coagulation is effective treatment for keloid scarring.

Prevention and reduction of scarring in the skin by Transforming Growth Factor beta 3 (TGFβ3): from laboratory discovery to clinical pharmaceutical

“…Although a range of treatments and regimens have been evaluated, with some success reported, no single therapy has been adopted as a universally accepted treatment [4]. These treatments and regimens include: compression therapies (e.g., silicon sheets/gels, pressure garments, ear clips, hydrating creams/ointments) [ 5 -11]; surgical excision (shave, fusiform or elliptical excision) [4,12]; corticosteroid therapy [8, 10 -17]; radiotherapy [18,19]; laser therapy [8, 20 -29]; cryotherapy [8, 30 -34]; anti-neoplastics (e.g, 5-fluorouracil) [35,36]; retinoic acid [37,38]; Verapamil [9]; and immunomodulators (e.g., Imoqimod and gamma interferon) [23]. Current therapies used in clinical practice tend to be typically empirical, require high levels of patient compliance and/or multiple clinical visits, are associated with high scar recurrence rates and have not been proven to be efficacious in prospective, well controlled, blinded clinical studies with defined, robust and relevant efficacy endpoints [39].…”

Management of ear lobule keloids using 980-nm diode laser

“…This modality is quite painful and requires general anesthesia [3]. In a clinical study on 17 patients, it was reported that Nd:YAG-laser effected full flattening of keloids in 60% of patients at 3 months with complete resolution of the remaining patients achieved by intralesional triamcinolone acetonide [27]. Carbon dioxide laser has been tried alone for keloid removal, by excision or ablation, but high recurrence rate was reported within 1 year of follow-up [12,[28][29][30][31].…”

Scar Revision Review

“…47 The 1064-nm Nd:YAG nonablative laser has been shown to selectively suppress collagen production in fibroblast cultures, 48 and clinical studies have shown some promise in the treatment of scars. 49,50 Cho et al 51,52 evaluated the efficacy and safety of the 1064-nm Q-switched Nd:YAG laser with low fluence on keloids and hypertrophic scars. Their results showed a decrease in the mean score for the following lesion characteristics: pigmentation, vascularity, pliability, and height, indicating that this may be a potential treatment option for hypertrophic scars.…”