A Comparative Study of Fractional CO₂ Laser Mediated Topical Triamcinolone Versus Intralesional Acetonide in the Treatment of Keloid Scars
Keywords:
Keloid; Fractional CO2 laser; Triamcinolone acetonide; Laser-assisted drug delivery; Intralesional injectionAbstract
Objective: Pathological scars, particularly keloids, cause significant physical and emotional distress. This study compared the effectiveness, safety, and patient satisfaction of fractional CO₂ laser with topical triamcinolone versus intralesional triamcinolone acetonide (ILTA).
Methods: This prospective interventional study included 24 patients with keloids. Group A received fractional CO₂ laser followed by topical triamcinolone, while Group B received intralesional triamcinolone acetonide (ILTA, 10–40 mg/mL). Both groups underwent two treatment sessions, with scars assessed using the Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS) at baseline, during treatment, and 3 months post-treatment.
Results: Both treatments produced significant clinical improvement (VSS, P < 0.001), with no significant difference between groups (P > 0.05). However, POSAS scores significantly favored fractional CO₂ laser with topical triamcinolone (P < 0.05), indicating better scar pliability, symptom relief, and patient satisfaction.
Conclusion: Ablative Fractional CO2 laser with topical triamcinolone demonstrates comparable clinical efficacy to conventional intralesional steroid therapy in keloid management. Notably, the laser-assisted approach offers superior patient tolerability and satisfaction, making it a valuable, minimally invasive alternative.
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