INTRODUCTION
Keloids are benign dermal fibroproliferative tumors, manifesting as thickened, raised scars that arise due to injury.1 Keloids grow beyond the wound boundaries and appear firm, smooth, shiny, and may be dyschromic. They can cause psychosocial, physical, and cosmetic distress. Keloids often arise in patients with skin of color and can be caused by trauma to the skin, including physical injury, surgery, piercings, burns, and acne lesions.2-5 The pathophysiology of keloid formation is complex and poorly understood. Researchers believe that keloids form due to overproduction of collagen and fibroblasts with increased levels of transforming growth factor and platelet-derived growth factor.6
Common treatment therapies include intralesional corticosteroid injections, silicone gel sheets, pressure therapy, cryotherapy, and surgical excision.7,8 There is no universal treatment protocol for keloids due to their heterogeneity. Keloids remain a challenging dermatologic condition to treat due to their high recurrence rate, complex pathogenesis, size and location, and limited standardization. Energy-based device therapies (EBDs) such as laser therapy, radiofrequency therapy, and intense pulsed light (IPL) have emerged as potential non-invasive, and effective methods of reducing the appearance of keloids.9 These EBDs target blood vessels within the keloid tissue to decrease inflammation, help remodel collagen to flatten and soften the keloid, and reduce pigmentation by breaking down the melanin within the scar tissue. Laser therapy can also be used in combination with other treatments, such as corticosteroid injections, to further decrease keloid appearance and prevent reoccurrence.10
This review explores different EBD therapies, such as lasers in combination with other modalities and laser monotherapy, as well as the efficacy of radiofrequency and intense pulsed light in treating keloids.
Common treatment therapies include intralesional corticosteroid injections, silicone gel sheets, pressure therapy, cryotherapy, and surgical excision.7,8 There is no universal treatment protocol for keloids due to their heterogeneity. Keloids remain a challenging dermatologic condition to treat due to their high recurrence rate, complex pathogenesis, size and location, and limited standardization. Energy-based device therapies (EBDs) such as laser therapy, radiofrequency therapy, and intense pulsed light (IPL) have emerged as potential non-invasive, and effective methods of reducing the appearance of keloids.9 These EBDs target blood vessels within the keloid tissue to decrease inflammation, help remodel collagen to flatten and soften the keloid, and reduce pigmentation by breaking down the melanin within the scar tissue. Laser therapy can also be used in combination with other treatments, such as corticosteroid injections, to further decrease keloid appearance and prevent reoccurrence.10
This review explores different EBD therapies, such as lasers in combination with other modalities and laser monotherapy, as well as the efficacy of radiofrequency and intense pulsed light in treating keloids.
MATERIALS AND METHODS
A literature review was performed using SCOPUS and PubMed databases to explore contemporary applications of lasers in keloid treatment. The search covered studies published between January 2011 and September 2023. The primary search terms "keloid," "lasers," "combination therapy," "Nd:YAG," "fractional CO2," "pulsed dye," "radiofrequency," and "intense pulse light" were used as isolated and combined search terms. Inclusion criteria encompassed English-language articles of various study types, such as randomized controlled trials, systematic reviews, clinical trials, retrospective single-center studies, case series, and case reports. Exclusion criteria included non-English studies. The review aimed to analyze efficacy compared to
