Laser and light-based treatment of Keloids - A review

Background Keloids are an overgrowth of fibrotic tissue outside the original boundaries of an injury and occur secondary to defective wound healing. Keloids often have a functional, aesthetic, or psychosocial impact on patients as highlighted by quality-of-life studies. Objectives Our goal is to provide clinicians and scientists an overview of the data available on laser and light-based therapies for treatment of keloids, and highlight emerging light-based therapeutic technologies and the evidence available to support their use. Methods We employed the following search strategy to identify the clinical evidence reported in the biomedical literature: in November 2012, we searched PubMed.gov, Ovid MEDLINE, Embase and Cochrane Reviews (1980-present) for published randomized clinical trials, clinical studies, case series and case reports related to the treatment of keloids. The search terms we utilized were 'keloid(s)' AND 'laser' OR 'light-emitting diode' (LED) OR 'photodynamic therapy' (PDT) OR 'intense pulsed light' OR 'low level light' OR 'phototherapy.' Results Our search yielded 347 unique articles. Of these, 33 articles met our inclusion and exclusion criteria. Conclusion We qualitatively conclude that laser and light-based treatment modalities may achieve favourable patient outcomes. Clinical studies using CO₂ laser are more prevalent in current literature and a combination regimen may be an adequate ablative approach. Adding light-based treatments, such as LED phototherapy or PDT, to laser treatment regimens may enhance patient outcomes. Lasers and other light-based technology have introduced new ways to manage keloids that may result in improved aesthetic and symptomatic outcomes and decreased keloid recurrence.