Pilot Study of the Efficacy of 578 nm Copper Bromide Laser Combined with Intralesional Corticosteroid Injection for Treatment of Keloids and Hypertrophic Scars

Abstract

Background: Treatments including intralesional corticosteroid injection, pressure therapy, cryotherapy, and various laser therapies have had limited success for keloids and hypertrophic scars.

Objective: This trial evaluated the efficacy of a combination of 578 nm copper bromide laser and the more traditional intralesional corticosteroid injection for the treatment of keloids and hypertrophic scars with respect to scar color.

Methods: Keloids or hypertrophic scars of 12 Korean patients were treated five times by the combined treatment at 4-week intervals. Clinical improvement was assessed by the physicians' global assessment (PGA) comparing pre- and post-treatment photographs, as well as 4 weeks after the last treatment. Erythema intensity was quantified using a mexameter.

Results: Most scars showed significant clinical improvement in PGA and decreased erythema intensity after 5 treatments. All patients showed improvements in symptoms like pruritus.

Conclusion: The combined treatment is effective for keloids and hypertrophic scars, especially when the telangiectatic portion of the scars is prominent. The adjunctive use of 578 nm copper bromide laser decreased the telangiectatic side effects of an intralesional corticosteroid injection by reducing the vascular components of scars.

Keywords: 578 nm copper bromide laser; Hypertrophic cicatrix; Intralesional corticosteroid injection; Keloid.

Fig. 1

Keloid on the presturnal area in a 63-year-old man (case 3). (A) Before the initiation of treatment; (B) at 4 weeks after the final treatment.

Fig. 2

Hypertrophic scar on the right wrist in a 23-year-old woman (case 12). (A) Before the initiation of treatment; (B) at 4 weeks after final treatment.

Fig. 3

Quantification of (a^*) at the telangiectatic erythema of the scars before treatment, and at 4 weeks after the fifth treatment.