Laser CO2 versus radiotherapy in treatment of keloid scars.

Keloids and hypertrophic scars are quite common diseases that can occur after any kind of wound and skin inflammation in predisposed individuals. Despite their benign nature, they can be aesthetically disabling and they are often accompanied by unpleasant symptoms such pain, burning and itching. Several approaches have been tried but most of them with poor results. Ablative fractional CO(2) laser seems to be an encouraging approach in treatment of keloids and hypertrophic scars, not only for its efficacy, but also for its low harmfulness. Radiotherapy following surgical excision is commonly used to treat these scars, but an increased incidence of different kinds of cancer from radiation has been demonstrated in several cases. Compared to radiotherapy, the use of CO(2) laser after surgical excision of keloids has shown great results with no recurrence and without the risk of carcinogenesis.

Treatment of hypertrophic scars and keloids with a fractional CO2 laser: a personal experience.

Keloids and hypertrophic scars are both abnormal wound responses in predisposed individuals but they differ in that keloids extend beyond the original wound and almost never regress, while hypertrophic scars remain within the original wound and tend to regress. How keloids grow is not totally clear because there is no animal model; in fact, keloids affect only humans. Different injuries can result in keloids, including burns, surgery, ear piercing, lacerations, abrasions, tattooing, vaccinations, injections, insect bites and any process causing skin inflammation (chicken pox, acne, folliculitis, zoster). Skin or wound tension is considered a critical factor in the formation of keloids and hypertrophic scars. This study is based on eight consecutive patients (four females and four males, F:M = 1:1) with a total of 12 keloids. All of whom were treated monthly with a MiXto SX CO(2) laser, using 13 W of power, 8 SX of index and 40% coverage (density) in combination with Same Plast Gel(®) twice a day. Each scar required 12 treatments, and all the patients, followed up for 1 year after the last treatment, had optimum results and no recurrence.