Role of fractional CO2 laser with intralesional steroid versus intralesional steroid alone in treatment of hypertrophic scar and keloids

Abstract

Background: Hypertrophic scars and keloids are fibrous responses resulting from burns, surgery, inflammation, or trauma. Keloids are believed to form due to an imbalance between collagen synthesis and degradation in the extracellular matrix, leading to increased fibroblast density and proliferation. They commonly appear in individuals aged 10 to 30 and typically affect areas of high skin tension, including the upper back, shoulders, chest, and upper arms. Patients often experience not only cosmetic concerns but also pain, itching, limited mobility, and psychological issues. Various treatment options have been proposed, such as surgery, intralesional steroid injections, laser therapy, and cryosurgery, but the effectiveness of these methods can vary. Materials and Methods: In this prospective randomised controlled study, 30 patients, Patients with keloids and hypertrophic scar are divided into two groups with 15 in each group, one group is receiving fractional co2 laser and intralesional triamcinolone acetonide and another group receiving intralesional triamcinolone acetonide alone. Pretreatment measurements and photographs will be documented and the Scar is assessed through Patient and observer scar assessment scale (PAOSAS). The treatment will be given at every 4 week interval until the keloids were resolved. Conclusion: Intrathecal Bupivacaine with Buprenorphine 60 μg caused prolonged duration of postoperative analgesia when compared to intrathecal Bupivacaine with Nalbuphine 2 mg. (10).