Laser treatment of keloids and hypertrophic scars.
BACKGROUND
Lasers have been used in the treatment of hypertrophic scars and keloids for more than 20 years. Different laser systems have been examined; among them pulsed dye lasers are currently considered the laser of choice in these settings.


OBJECTIVE
The purpose of this study is to review the pertinent literature and provide updated information on different laser therapies available for treatment of keloids and hypertrophic scars.


METHODS
A Medline literature search was performed for relevant publications.


RESULTS
In this review the results of published studies in the treatment and prevention of hypertrophic scars and keloids are presented. Suggested mechanisms of action are reviewed. A review of the optimal laser parameters to modulate treatment outcome will be discussed. Different lasers are effective in not only the treatment but also the prevention of hypertrophic scars and keloids, among them PDL is more promising. Most of the suggested theories are based on the selective photothermolysis in which the light energy emitted from a vascular laser is absorbed by hemoglobin, generating heat and leading to coagulation necrosis, neocollagenesis, collagen fiber heating with dissociation of disulfide bonds and subsequent collagen fiber realignment.


CONCLUSIONS
The optimal laser is currently 585 nm PDL, although the recent results of Q-switched 532 nm frequency-doubled Nd:YAG are promising. Early use of lasers are beneficial, especially in those who are prone to develop these lesions.
Bouzari
Navid
N
Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida, USA.
Davis
Stephen C
SC
Nouri
Keyvan
K
D017439:Cicatrix, Hypertrophic / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007627:Keloid / Q000503:physiopathology / Q000601:surgery*; D053685:Laser Therapy; D016896:Treatment Outcome