The use of laser monotherapy in the treatment of keloids and hypertrophic scars: A look at the carbon dioxide laser. A systematic review and meta-analysis.

To evaluate the effectiveness of fractional CO2 laser monotherapy in treating HS and keloids compared to other laser treatments. A systematic review and meta-analysis were conducted by searching Medline, PubMed, and Cochrane databases for studies comparing fractional CO2 laser therapy to other laser treatments for hypertrophic scars and keloids. Data were analyzed using IBM SPSS Statistics, assessing Vancouver Scar Scale scores, percent improvement in scar characteristics, and patient satisfaction. The search yielded 8,656 articles, with seven studies meeting the inclusion criteria. Analysis included 404 patients with 506 scars. The meta-analysis showed that CO2 laser treatment resulted in significantly better mean VSS scores and percent improvement compared to other lasers. However, there were no significant differences in color, pliability, height, or vascularity improvements and patient satisfaction rates. Fractional CO2 laser therapy is effective in improving the appearance of HS and keloids, with superior outcomes in VSS scores compared to other lasers. Further studies are needed to confirm these findings and to explore combination therapies.