Treatment of keloids and hypertrophic scars with the triple-mode Er:YAG laser: A pilot study

Introduction

Hypertrophic scars and keloid formation are common problems which are not only the result of surgical procedures. Many treatment protocols exist without standardization. The aim of our study was to compare various treatment protocols using a 2940 nm Er:YAG laser with and without additional silicone gel application.

Patients and methods

Twenty-one patients suffering from keloids or hypertrophic scars were treated in four groups with the Burane XL Er:YAG laser (Quantel Derma GmbH; Erlangen, Germany) either in thermal or combined thermoablative mode with or without additional silicone gel application under non-blinded conditions. The appearance of the scars (redness, hardness and elevation) before therapy, and 12 months after therapy was evaluated by therapists based on a scaling system from 0 to 3 (0 = minimum, 3 = maximum).

Results

The patient group was made up of 21 people, 16 females and five males, ranging in age from 16 to 79 years. All patients had a mean reduction of redness, hardness and scar elevation by 51.3% (p = 0.0012), 48.9% (p = 0.0015) and 50.0% (p = 0.0015), respectively. There was no significant difference between groups with or without additional silicone gel application (p > 0.05).

Conclusion

Our pilot study proved the effectiveness of Er:YAG laser treatments (thermal and combined thermoablative mode) for the reduction of hypertrophic scars and keloids. However, the additional application of silicone gel was not as effective as postulated. Larger randomized double-blinded studies are needed to further evaluate treatment protocols for hypertrophic scars and keloids.