Treatment of keloid scars using light-, laser- and energy-based devices: a contemporary review of the literature

Forbat, Emily; Ali, Faisal; Al‐Niaimi, Firas

doi:10.1007/s10103-017-2332-5

Cited by 23 publications

(30 citation statements)

References 40 publications

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“…100 These lasers induce thermal injury to the scar's microvasculature leading to thrombosis and ischaemia which result in collagen denaturation and collagen fibre realignment. [101][102][103] Laser therapy requires several treatments at intervals of 4-8 weeks, depending on scar type and type of laser used 98,104 with possible side effects including itching, pigmentary changes, blister formation and postoperative purpura. 98 The use of the non-fractional, vascular 585-595 nm PDL in the treatment of keloid and hypertrophic scars has been well-documented [105][106][107][108] and has response rates in the range of 57%-83%.…”

Section: Laser Therapymentioning

confidence: 99%

Keloids: Current and emerging therapies

Ojeh

Bharatha

Gaur

et al. 2020

Scars, Burns & Healing

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Keloids are pathological scars that grow over time and extend beyond the initial site of injury after impaired wound healing. These scars frequently recur and rarely regress. They are aesthetically disfiguring, can cause pain, itching, discomfort as well as psychological stress, often affecting quality of life. Many treatment modalities, including surgical and non-surgical, have been explored and have been reported to be beneficial; however, none have been absolutely satisfactory or optimal for the treatment of all keloid subtypes to date. This poses a major challenge to clinicians. Often, a combinational therapeutic approach appears to offer the best results with higher patient satisfaction compared to monotherapy. The aetiopathogenesis of keloids is not fully elucidated; however, with recent advances in molecular biology and genetics, insight is being gained on the complex process of scar formation and hence new therapeutic and management options for keloids. In this paper, we explore the literature and summarise the general concepts surrounding keloid development and review both current (corticosteroids, surgical excision, silicone-based products, pressure therapy, radiotherapy, cryotherapy, laser therapy, imiquimod and 5-fluorouracil) and emerging (stem cell therapy, mitomycin C, verapamil, interferons, bleomycin, botulinum toxin type A and angiotensin-converting enzyme inhibitors) treatments. Increased knowledge and understanding in this area may potentially lead to the discovery and development of novel therapeutic options that are more efficacious for all keloid types. Lay Summary [Formula: see text] Keloids are problematic scars that are difficult to treat and manage. The aetiopathogenesis of keloids is not clear; however, recent advances in molecular biology and genetics are beginning to shed light on the underlying mechanisms implicated in keloid scar formation which will hopefully lead to the development of treatment options for all keloid types. This review summarises current and emerging therapies.

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Section: Laser Therapymentioning

confidence: 99%

Keloids: Current and emerging therapies

Ojeh

Bharatha

Gaur

et al. 2020

Scars, Burns & Healing

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“…Scars have a multitude of causes, including burns, acne, trauma, surgery and are a very common reason for dermatological consultation. The authors surmise the use of PDL lasers in keloid scars, demonstrating PDL and ablative lasers (such as the CO 2 laser) are the most widely trialed lasers for keloid scars . We reviewed 22 studies over the last 20 years for the use of PDL independently or in comparison or conjunction/comparison to Erbium‐glass laser, fractional CO 2 laser, Nd:YAG, botulinum toxin, KTP, low‐level laser, different parameters and wavelengths of PDL, triamcinolone/5‐FU, IPL in 477 scars including: hypertrophic, keloidal, burns, and traumatic.…”

Section: Scarsmentioning

confidence: 99%

Nonvascular uses of pulsed dye laser in clinical dermatology

Forbat

Al‐Niaimi

2019

J of Cosmetic Dermatology

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Lasers are fast becoming the vogue of dermatology ranging from ablative, nonablative, fractional photothermolysis to vascular lasers. There are a range of vascular lasers including potassium titanyl phosphate (KTP 532 nm), pulsed dye laser (PDL −595 nm), diode (810 nm), and Nd:YAG (1064 nm). PDL is a laser that emits yellow light using Rhodamine dye as it is lasing medium. Typical vascular lesions which are treated by PDL include port wine stain, hemangioma, telangiectasia, spider angioma, and rosacea. This article focuses on the use of PDL beyond primary vascular conditions. We review the evidence, or lack thereof, of the use of PDL in acne vulgaris, scars, striae, warts, molluscum, psoriasis, rejuvenation, basal cell carcinoma (BCC), and miscellaneous dermatological sequelae. K E Y W O R D Sacne, laser, nonvascular, psoriasis, pulsed dye, scar

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“…Owing to the rarity of this adverse effect (AE), even with our centre's extensive experience using these parameters, it remains impossible to establish whether high Nd:YaG laser fluency contributed to the development of this AE. Interestingly, laser therapy, either as a stand‐alone treatment or as an adjunct to medical therapy is a novel treatment option for keloid scarring . Fractionated CO 2 , Nd:YaG and PDL laser have all shown significant efficacy in improving the appearance of keloid scarring.…”

Section: Laser Parameters Used For Our Patientmentioning

confidence: 99%

“…Interestingly, laser therapy, either as a stand-alone treatment or as an adjunct to medical therapy is a novel treatment option for keloid scarring. 5 Fractionated CO 2 , Nd:YaG and PDL laser have C P D all shown significant efficacy in improving the appearance of keloid scarring 6 . Nevertheless, whether our patient should undergo further laser treatment for either her PWS or the keloid scar is still undetermined.…”

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confidence: 99%