Ablative Fractional Lasers with Corticosteroids

Compare To Other Treatments

What Is It?

Ablative fractional lasers attempt to reduce the size of raised scars by shining an intense beam of light on the scar in a dot-matrix (imagine tiny polka dots) pattern, which completely removes (ablates) the skin in this dot-matrix pattern, leaving some of the skin intact. 

Zapping away the old, damaged skin leaves a new scar behind. The newly formed scar is smaller than the old one and contains less collagen.

Next, corticosteroids are injected or applied topically to reduce the size and thickness of the scar further.

This treatment is normally repeated 3-5 times in 4-week intervals, but more or less sessions are sometimes required. You should see gradual results with each session. After your last session, your scar(s) should continue to improve. However, in some cases, scars may grow back after treatment.

Good or Excellent Response

Strength of Evidence
1
2
3
4
5
59% of patients achieved a good (>50%) or excellent (>75%) improvement in scarring

Scar Height Reduction

Strength of Evidence
1
2
3
4
5
Average 38% reduction in scarring

Scar Volume Reduction

Strength of Evidence
1
2
3
4
5
Average 57% reduction in scarring

Mean improvement in VSS total score

Strength of Evidence
1
2
3
4
5
Average 50% reduction in scarring

Mean improvement in VSS pigmentation score

Strength of Evidence
1
2
3
4
5
Average 100% reduction in scarring

Mean improvement in VSS height score

Strength of Evidence
1
2
3
4
5
Average 64% reduction in scarring

Mean improvement in VSS pliability score

Strength of Evidence
1
2
3
4
5
Average 48% reduction in scarring

Mean improvement in VSS vascularity score

Strength of Evidence
1
2
3
4
5
Average 44% reduction in scarring
▸ Based on These Clinical Studies & Trials
▾ Based on These Clinical Studies & Trials
  1. Tawaranurak, N., Pliensiri, P. & Tawaranurak, K. Combination of fractional carbon dioxide laser and topical triamcinolone vs intralesional triamcinolone for keloid treatment: A randomised clinical trial. International Wound Journal 19, 1729–1735 (2022).
  2. El-Azhary, E., Al-Salam, F. A., El-Hafiz, H. A. & Maghraby, H. Fractional carbon dioxide (CO₂) laser alone versus fractional CO₂ laser combined with triamcinolone acetonide or tricholoroacetic acid in keloid treatment: A comparative clinical & radiological study. Dermatology Practical & Conceptual e2022072–e2022072 (2022) doi:10.5826/dpc.1202a72.
  3. Manuskiatti, W. et al. Hypertrophic scar outcomes in fractional laser monotherapy versus fractional laser-assisted topical corticosteroid delivery: a randomized clinical trial. Acta Derm Venereol 101, adv00416 (2021).
  4. El-Dayem, D. H., Nada, H. A., Hanafy, N. S. & Elsaie, M. L. Laser-assisted topical steroid application versus steroid injection for treating keloids: a split side study. J Cosmet Dermatol 20, 138–142 (2021).
  5. Wang, J. et al. Combination therapy of refractory keloid with ultrapulse fractional carbon dioxide (CO2 ) laser and topical triamcinolone in Asians-long-term prevention of keloid recurrence. Dermatol Ther 33, e14359 (2020).
  6. Marques, T. F., Santos, M. F., Silva, I. da L., Lorenzini, F. K. & Manzoni, A. P. D. da S. Infiltração intralesional de corticosteroide x laser fracionado ablativo associado a drug delivery de corticosteroide no tratamento de queloides: um estudo comparativo. Surgical & Cosmetic Dermatology 12, 264–269 (2020).
  7. Waibel, J. S., Wulkan, A. J., Rudnick, A. & Daoud, A. Treatment of hypertrophic scars using laser-assisted corticosteroid versus laser-assisted 5-fluorouracil delivery. Dermatol Surg 45, 423–430 (2019).
  8. Alexander, S., Girisha, B. S., Sripathi, H., Noronha, T. M. & Alva, A. C. Efficacy of fractional CO2 laser with intralesional steroid compared with intralesional steroid alone in the treatment of keloids and hypertrophic scars. J Cosmet Dermatol 18, 1648–1656 (2019).
  9. Majid, I. & Imran, S. Fractional carbon dioxide laser resurfacing in combination with potent topical corticosteroids for hypertrophic burn scars in the pediatric age group: an open label study. Dermatol Surg 44, 1102–1108 (2018).
  10. Park, J. H., Chun, J. Y. & Lee, J. H. Laser-assisted topical corticosteroid delivery for the treatment of keloids. Lasers Med Sci 32, 601–608 (2017).
  11. Behera, B., Kumari, R., Thappa, D. M. & Malathi, M. Therapeutic efficacy of intralesional steroid with carbon dioxide laser versus with cryotherapy in treatment of keloids: a randomized controlled trial. Dermatol Surg 42, 1188–1198 (2016).
  12. Cavalié, M. et al. Treatment of keloids with laser-assisted topical steroid delivery: a retrospective study of 23 cases. Dermatol Ther 28, 74–78 (2015).

Side Effects

Medium-High
Medium-high side effects and adverse reactions

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