A keloid is a raised scar that can grow well beyond the original wound and keep enlarging over time. Fractional CO2 laser has become a promising option for treating keloids, with potential advantages over surgery and injections alone.
How Fractional CO2 Laser Helps
The laser creates microscopic columns of treated tissue, which offers several benefits for keloids:
- Precise targeting of keloid tissue while sparing surrounding healthy skin.
- Collagen remodelling: controlled treatment stimulates collagen renewal and healing to help reduce keloid growth.
- Lower pigmentation risk: it is less likely to cause post-inflammatory hyperpigmentation than fully ablative lasers, which matters for darker skin tones.
- Faster recovery than surgical excision.
- Improved appearance: it can flatten and shrink keloids.
Getting the Best Results
Before treatment
Identifying higher-risk patients, reducing keloid size first with corticosteroid injections or cryotherapy, and adapting laser settings to skin tone all improve outcomes.
Treatment settings
The dermatologist tailors energy (fluence), pulse duration and the density of the micro-treated zones to the keloid's depth and thickness, sometimes adding focused treatment in the centre of the scar.
After treatment
Careful wound care with antiseptic cleansers, moisturisers and silicone gel sheeting supports healing. Strict sun protection with sunblock for several months helps prevent pigmentation and recurrence, alongside regular follow-up.
Combination Therapy
Pairing fractional CO2 with steroid injections, cryotherapy or, in some cases, growth-factor therapy may further improve results and lower recurrence rates. Treatments such as chemical peeling and microneedling may also support overall scar care under specialist guidance.
Limitations to Keep in Mind
Keloids can still recur after laser treatment, with reported rates varying widely depending on size, location and individual factors. Treatment can be costly and may need several sessions, and possible side effects include discomfort, a small risk of scarring or infection, and temporary lightening of the skin. Choosing an experienced, board-certified dermatologist and keeping realistic expectations are key.
The Bottom Line
Fractional CO2 laser can be a valuable tool for managing keloids, with advantages over older methods, but it is not a cure. Weigh the benefits and limitations with a qualified dermatologist who can build a personalised plan. Book at Derma & Dental Clinic, Bahria Town, Lahore, online at Dermatology.pk, WhatsApp +923205999650, or call 0304-1115000.
