The Effectiveness of a Multi-Modal Strategy Involving Laser Therapy and Steroid Injections for the Treatment of Keloids in Patients with Darker Skin Phototypes: A Case Series.

Background

Keloids and hypertrophic scars appear more frequently in people with darker skin tones, such as those of African, Asian, or Hispanic descent. The combination of CO2 laser, pulsed dye laser (PDL), and triamcinolone was successful in treating a keloid. Aim: The purpose of this research was to assess the clinical efficacy of a multi-modal treatment protocol comprising a 595 nm PDL, fractional ablative CO2 laser, 1540 nm nonablative laser, and intralesional corticosteroid injections for keloid management in Indian patients.

Methods

A total of 30 patients with keloids were treated with a combination of two different lasers (595 nm pulsed/10,600 nm and 1540 nm fractional laser) and intralesional steroids injections. Clinical images were collected before treatment and at 9 months after the last treatment, and adverse effects were monitored throughout the study. Patients were assessed with the Detroit Keloid Scale before treatment and at follow-up.

Results

After completing treatments, almost all patients showed improvement; in particular, a decrease in redness was noted, and the keloids appeared flatter. This improvement was also recorded through the Detroit Keloid Scale, where a significant 6-point decrease on the scale was recorded between baseline and follow-up (p < 0.01).

Conclusions

This combined therapy is a good option for people with darker skin tones since it has been proven as an effective tool for managing keloid, especially for enhancing texture and decreasing redness with a lower risk of postinflammatory hyperpigmentation.