Comparison between fractional Co2 laser-triamcinolone injection combination therapy and triamcinolone injection monotherapy for keloid

The histopathologic view of keloid shows dense fibroblasts and bundles of collagen throughout dermis. Treatment that completely cure keloid still not exist, although there are many treatment options. The monotherapy fractional CO₂ laser shows good results, but is still as an adjuvant therapy. Fractional CO₂ laser affects fibroblast and its functions in producing collagen. The combination therapy will combine the selective phototermolysis effect of CO₂ lasers with antimitotic and antiinflammatory effects of corticosteroids. This study was an open trial with parallel design that compared fractional CO₂ laser-intralesional triamcinolone acetonide combination therapy (treatment group) and intralesional triamcinolone acetonide (control group) in keloid patients with collagen density as evaluation parameter. The dose of triamcinolone was 10 mg/ml of 0.05-0.1 ml/cm² of keloid. Fractional CO₂ laser energy setting was 10-20 mJ. The decrease of collagen density in control and treatment group was significant (p=0.008 and p=0.001), although the decrease difference between control and treatment group was not significant (p=0.328). The collagen density that decrease in a shorter time shows that fractional CO₂ laser could be a good combination therapy.