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Keloid-Related Pain Reduced with 1064-nm Nd:YAG Laser

A majority of patients with a symptomatic keloid treated with a 1064-nm Nd:YAG laser exclusively saw a total resolution in pain after treatment. The study results were published in Lasers in Surgery and Medicine.

The authors noted how keloids have recently been successfully treated with Nd:YAG laser in conjunction with 5-fluorouracil and intralesional corticosteroids, so they sought to study the effects of Nd:YAG laser alone. In their study, eight patients with Fitzpatrick skin types I through VI presented for treatment of keloids with associated symptoms of pain. Of these patients, seven had previously been treated with intralesional steroid injections without resolution of symptoms, and keloids were mostly commonly located on the trunk.

Patients were treated with two passes under a long-pulsed 1064-nm Nd:YAG laser with a 10-mm spot size. Fluence was set between 18 to 19 J/cm2 with a pulse duration of 60 ms. Treatments were repeated every 3 to 8 weeks. Patients reported pain scores before and after treatments.

Following treatment, patients reported an improvement in pain with an average 5-point reduction on a 10-point scale (range, 2-10). Patients first noticed an improvement in pain after 3.25 treatments (range, 1-5). In total, five reported complete resolution of their pain. In addition, no patients experienced further scarring or pigmentary changes following treatment, but transient erythema and mild edema were noted.

Analysis of the results with Wilcoxon signed-rank test demonstrated a statistically significant improvement in keloid pain (z=2.46; P=.01), however, the study was limited by its sample size. The authors concluded that patients with keloids treated with 1064-nm Nd:YAG laser experience a significant reduction in pain.

Reference
Patel PM, Bakus AD, Garden BC, Lai O, Jones VA, Garden JM. Treatment of pain in keloids using only a long‐pulsed 1064 nm Nd:YAG Laser. Lasers Surg Med. Published online November 25, 2020. doi:10.1002/lsm.23363

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