Comparative Study between Nd‐YAG laser, fractional CO2 Laser, and combined Nd‐YAG with fractional CO2 Laser in the Management of keloid: clinical and molecular Study

Abstract

Background Fractional CO2 laser and Nd‐YAG laser have been reported to have promising results in the management of keloids. So far, there have been no comparative studies between these laser modalities. Aims The study aimed to compare the efficacy of fractional CO2, Nd‐YAG, and a combination of both in the management of keloids. Patients and methods Forty‐five keloid patients were divided into 3 equal groups: the first received fractional CO2 only, the second received Nd‐YAG only, and the third received a combination of both lasers. Each group received its designated treatment every 4 weeks for 4 sessions. The improvement was evaluated by the “Patient and Observer Scar Assessment Scale” (POSAS). Detection of procollagen I mRNA by RT‐PCR analysis was done. Results The assessment by POSAS showed the most significant clinical improvement in the combination group and a less significant improvement in the fractional CO2 group, while the least improvement was seen in the Nd‐YAG group. Molecular assessment via procollagen I yielded matching results. Conclusion The study showed that the combination of fractional CO2 and Nd‐YAG lasers has a synergistic effect being the most effective in the management of keloids, fractional CO2 being more effective than ND‐YAG and Nd‐YAG being the least effective.

Comparison of Fractional CO2 Laser with Intralesional Verapamil versus Fractional CO2 Laser with Intralesional Triamcinolone for the Treatment of Keloid

“…Regarding Fitzpatrick skin type, we recorded type III, IV, V skin type in 35%, 50%, 15% of patients respectively. This was near similar to another Egyptian study conducted by Soliman et al (23) who reported that the most common Fitzpatrick Skin type was type IV in 48.9% of the patients with keloid followed by type III in 46.7% of the patients, while type II was the least common in 4.4% of the patients. The Fitzpatrick skin type has a significant impact on the epidemiology of keloids, with incidences ranging from 4.5 percent to 16 percent in type VI to just 0.09 percent in type I (24) .…”

Treatment of an ear keloid refractory to intralesional triamcinolone injection monotherapy with fractional CO2 laser and triamcinolone combination therapy: a case report

“…Fractional CO2 laser is reported to be the most effective modality [9]. Fractional CO2 treatment of keloids resulted in a significant decrease in procollagen I compared to Nd:YAG laser and histologically improved arrangement of collagen bundles and increased MMP9 [11,12].…”

Application of fractional carbon dioxide laser monotherapy in keloids: A meta‐analysis

“…There are 12 items, each with a mean score of 0-2, for a total of 24 points. The studies are categorized by score as "moderate quality" (9)(10)(11)(12)(13)(14)(15)(16) and "high quality" (17)(18)(19)(20)(21)(22)(23)(24). The metaanalysis was performed in accordance with the relevant items in the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) statement.…”