Laser‐assisted topical steroid application versus steroid injection for treating keloids: A split side study

Abstract

Approaches to improve keloid scars include intralesional corticosteroid injections and fractional lasers exclusively. The combinative use of ablative fractional laser therapy and occluded topical corticosteroid as a drug delivery method enhances therapeutic outcome of two efficient scar therapy modules into one simple synergistic module. To compare the therapeutic effect of combining two modalities of scar treatment, the first is fractional ablative laser treatment and the other is occluded topical corticosteroid to the standard use of intralesional steroid injection. Keloids from thirty suffering patients were split faced into two identical parts; one part received an intralesional corticosteroid injection while the other part was treated first with fractional ablative 2940nm Er: YAG laser followed by occluded topical application of steroid cream. Four treatment sessions were performed with 4-week interval between sessions. Every session was assessed photographically and using the Vancouver Scar Scale (VSS). The mean keloid VSS before treatment was 6.9±1.9. After treatment, the mean keloid VSS of the injection side became 2.63±2.09, and mean keloid VSS of the laser-treated side became 2.07±2.02. Each of the treated halves showed a statistically significant improvement in their VSS. However, no statistically significant differences were observed for either of the treated halves over the other one. Although intralesional steroids injection is the standard procedure for treatment of keloid scars, the use of ablative fractional laser-assisted delivery of topical steroid can offer a safer and a better aesthetic treatment option.