Application of fractional carbon dioxide laser monotherapy in keloids: A meta‐analysis

• Published in: Journal of cosmetic dermatology 2024-04, Vol.23 (4), p.1178-1186
• Main Authors: Wang, Jinhui, Yu, Qi, Zhou, Qiujun, Tao, Maocan, Cao, Yi, Yang, Xiaohong
• Format: Article
• Language: English
• Subjects: Aesthetics; Animal research; Carbon dioxide; efficacy; fractional CO2 laser; keloids; Lasers; Meta-analysis; Patients; safety; Scars; Sensitivity analysis; systematic review and meta‐analysis; Wound healing
• ISSN: 1473-2130; 1473-2165
• DOI: 10.1111/jocd.16106

Background There is no evidence‐based guidance on the use of fractional CO2 laser in the excision of scars. Aim To explore the effectiveness and safety of fractional CO2 laser in the treatment of keloids. Methods In this meta‐analysis, we searched the PubMed, Embase, and Cochrane databases from inception to April 2023. We only included studies reporting fractional CO2 laser treatment of keloids. We excluded duplicate published studies, incomplete studies, those with incomplete data, animal experiments, literature reviews, and systematic studies. Results The pooled results showed that the Vancouver Scar Scale (VSS) parameters of height weighted mean difference (WMD) = −1.10, 95% confidence interval (CI): −1.46 to −0.74), pigmentation (WMD = −0.61, 95% CI: −1.00 to −0.21), and pliability (WMD = −0.90, 95% CI: −1.17 to −0.63) were significantly improved after fractional CO2 laser treatment of keloids. However, vascularity did not significantly change. Additionally, the total VSS was significantly improved after treatment (WMD = −4.01, 95% CI: −6.22 to −1.79). The Patient Scars Assessment Scale was significantly improved after treatment (WMD = −15.31, 95% CI: −18.31 to −12.31). Regarding safety, the incidences of hyperpigmentation, hypopigmentation, pain, telangiectasia, and atrophy were 5%, 0%, 11%, 2% (95% CI: 0%–6%), and 0% (95% CI: 0%–4%), respectively. Conclusions Fractional CO2 laser is effective in the treatment of keloids and can effectively improve the height, pigmentation, and pliability of scars, and patients are satisfied with this treatment. Further studies should explore the role of combination therapy.