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Laser Comparison in Keloid Management


A comparative study examines Fractional CO2 and Nd‐YAG laser effectiveness in keloid management.

A comparative study published in the Journal of Cosmetic Dermatology, examined the efficacy of a fractional CO2 laser and a Nd‐YAG laser as use in keloid management.1 It is currently the only study to compare the 2. 

The study had 3 cohorts: fractional CO2, Nd-YAG, and a combination of both for keloid management. 45 patients who were diagnosed with keloids enrolled into the 3 groups equally. Each of the groups received their designated treatment every 4 weeks for 4 sessions, breaking down to 1 session a month for 4 months. Improvement of keloids was evaluated by the Patient and Observer Scar Assessment Scale (POSAS) and detection of procollagen I messenger ribonucleic acid (mRNA) by reverse transcription polymerase chain reaction (RT‐PCR) analysis was done to confirm observation. 

Once data was received, the assessment by POSAS demonstrated that the most significant clinical improvement was in the combination group. Less significant improvement was found in the fractional CO2 group and the least improvement was seen in the Nd-YAG group. Additionally, the results matched when the molecular analysis was done by RT-PCR. 

In the end, the study findings show that the combination of fraction CO2 and Nd-YAG laser were the most effective in the management of keloids. This was due to the synergistic effect the combination achieved. It was also found that the fractional CO2 laser was more effective than the Nd-YAG in stand alone treatment. 

Further analysis is needed to determine the long-term safety data for the combination treatment. 


1. Soliman M, Etman Y, AbdElhameed A, Elsharaby R, Tawfik A. Comparative study between nd-yag laser, fractional co2 laser, and combined nd-yag with fractional co2 laser in the management of keloid: clinical and molecular study. Journal of Cosmetic Dermatology. 2021;20(4):1124-1132. doi:https://doi.org/10.1111/jocd.13920

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