Laser-assisted topical steroid application may be a safer and more efficacious alternative to steroid injection for the treatment of keloid scars, study data published in the Journal of Cosmetic Dermatology suggests. However, the long-term outcomes of this treatment methodology remain unclear.

In a Letter to the Editor, authors Xinhang Dong, MD, Mingzi Zhang, MD, Chengcheng Li, MD, and Xiaolei Jin, MD, provided commentary on a prior study and offered suggestions for future research.1 The study of interest, published in early 2020, enrolled 30 patients with keloids.2

All patients underwent 4 sessions of fractional ablative 2940-nm Er:YAG laser treatment. The Vancouver Score Scale (VSS) was used to assess keloid appearance at the pre- and post-treatment time points. Overall, patients achieved significant improvements per the VSS.

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A total of 3 patients (10%) reported itching and tingling sensations during long-term follow-up. Authors Dong et al suggested that such symptoms may be signs of keloid recurrence. However, study follow-up concluded after 12 weeks, preventing further assessment.

Although the study concluded that patients with keloids of all durations experienced improvements, Dong et al believe that shorter duration keloids may be better-suited for laser treatment. Keloids of short duration appear to have improved blood flow compared with longer term keloids, which may affect laser response. Further research on blood perfusion in the keloid boundary is necessary, as are additional studies on laser-assisted steroid treatments.


1. Dong X, Zhang M, Li C, Jin X. Letter to the editor. Laser-assisted topical steroid application vs steroid injection for treating keloids: a split side study. J Cosmet Dermatol. 2021;20(4):1355-1356 doi:10.1111/jocd.13964

2. Abd El-Dayem DH, Nada HA, Hanafy NS, Elsaie ML. Laser-assisted topical steroid application versus steroid injection for treating keloids: a split side study. J Cosmet Dermatol. 2021;20(1):138-142. doi:10.1111/jocd.13521