The Effectiveness of a Multi-Modal Strategy Involving Laser Therapy and Steroid Injections for the Treatment of Keloids in Patients with Darker Skin Phototypes: A Case Series.

Abstract

Background: Keloids and hypertrophic scars appear more frequently in people with darker skin tones, such as those of African, Asian, or Hispanic descent. The combination of CO₂ laser, pulsed dye laser (PDL), and triamcinolone was successful in treating a keloid. Aim: The purpose of this research was to assess the clinical efficacy of a multi-modal treatment protocol comprising a 595 nm PDL, fractional ablative CO₂ laser, 1540 nm nonablative laser, and intralesional corticosteroid injections for keloid management in Indian patients. Methods: A total of 30 patients with keloids were treated with a combination of two different lasers (595 nm pulsed/10,600 nm and 1540 nm fractional laser) and intralesional steroids injections. Clinical images were collected before treatment and at 9 months after the last treatment, and adverse effects were monitored throughout the study. Patients were assessed with the Detroit Keloid Scale before treatment and at follow-up. Results: After completing treatments, almost all patients showed improvement; in particular, a decrease in redness was noted, and the keloids appeared flatter. This improvement was also recorded through the Detroit Keloid Scale, where a significant 6-point decrease on the scale was recorded between baseline and follow-up (p < 0.01). Conclusions: This combined therapy is a good option for people with darker skin tones since it has been proven as an effective tool for managing keloid, especially for enhancing texture and decreasing redness with a lower risk of postinflammatory hyperpigmentation.