Combination laser treatment is effective for ear keloids, according to study data published in the Journal of Cosmetic Dermatology.

Researchers assessed the effectiveness of a combined protocol of CO2 laser + dyelaser compared with CO2 laser + dye laser + EnerJet (PerfAction) in patients with earlobe and helix keloids.

The study included 80 patients (41 men) aged 6 to 82 years of age (mean, 32 years) with a total of 83 ear keloids.

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In 1 treatment group, participants were treated in a single session with a CO2 laser procedure immediately followed by a pulsed dye laser; the second group of participants were treated in the same session with a single CO2 laser procedure, immediately followed by a pulsed dye laser procedure and an EnerJet procedure.

Of the 83 total lesions in all participants, 88.5% lesions did not recur, with 10 keloids recurring between the third and the twelfth month of follow-up.

Among the participants with 41 total treated keloids in the first group, 85.4% of the keloids did not recur during the follow-up of 3.5 years (3 months to 7 years), and 14.6% of the lesions recurred with mild thickening of the scar, and further treatments were performed.

In the second group of 40 treated patients with a total of 42 keloids and who also received the EnerJet, 90.5% of the keloids did not recur during a follow-up of 2 years (3 months to 2 years), and 9.5% of the lesions recurred with mild thickening of the scar, and additional treatments were administered.

“The effectiveness reported by our double or triple protocol is based on the concept of differentiating each lesion based on its size and on this basis, choosing to directly apply the CO2 laser therapeutic protocol followed by pulsed dye laser or possibly add an EnerJet session,” the researchers commented. “A pulsed dye laser session 40 days before is required in any lesion greater than 2.5 cm in diameter. Our results confirmed the disappearance of the lesion in the absence of recurrences in the 88% of cases, even over the long term, and even if these lesions have been treated with traditional surgery.”


Piccolo D, Crisman G, Bovani B, et al. Combined laser treatment for ear keloids: case series: comparison between two mini-invasive protocols. J Cosmet Dermatol. Published online November 10, 2021. doi:10.1111/jocd.14590