Lasers have a favorable synergistic effect when combined with other modalities of treatment against keloids. Different types of lasers have been used with triamcinolone infiltration, resulting in promising success rates.

The goal of a new study published in Lasers in Surgery and Medicine was to describe the first experience with treating earlobe keloids with 980 nm laser diode excision followed by triamcinolone infiltration, and to present outcomes after 24 months of follow-up.

This was a retrospective chart review of 11 patients with 14 earlobe keloids treated with excision using a 980 nm laser diode, followed by triamcinolone acetonide infiltration – between January 2015 and May 2016. Database included demographics, Fitzpatrick skin type, laterality, lesion size and postoperative visits information. Outcomes were assessed in terms of keloid recurrence rates, complications, and patient subjective aesthetical result satisfaction after 24 months of follow-up.

All procedures were technically completed, and follow-up accomplished without attrition. It was found that one (7.14%) patient experienced keloid recurrence after the third month. Four (28.57%) patients experienced early wound dehiscence—which was successfully treated with debridement and re-suture. While self-assessment of aesthetical result was considered "very good" in 64.28% of patients.

Hence, it was inferred that surgical excision with 980 nm laser diode followed by triamcinolone infiltration is well-tolerated and shows favorable results in treating earlobe keloids, and can be considered a first-line treatment. It was stated that comparison between different types of lasers and control groups in large clinical trials is warranted in order to obtain strong clinical evidence for clear indications and recommendations.

Source: Lasers in Surgery and Medicine. 2020 Aug 22. doi: 10.1002/lsm.23310.