Efficacy of Combination of Pulsed Dye Laser Followed by Triamcinolone Acetonide and Triamcinolone Acetonide Alone in the Treatment of Keloid

Abstract

Background: Keloids are abnormal scars that grow beyond the original wound. They cause cosmetic concerns, discomfort, and psychological distress. They are hard to manage effectively, as recurrence is common. Even with multiple treatment choices, there is no universally accepted therapy that is consistently effective. Objective: To assess the efficacy of pulsed dye laser (PDL) therapy followed by intralesional triamcinolone acetonide injection over intralesional triamcinolone acetonide injection alone in the management of keloids. 
Methods: A randomized controlled trial (RCT) was carried out in the Department of Dermatology & Venereology at Combined Military Hospital (CMH), Dhaka, from September to December 2016. In total, fifty patients with keloids were onboarded and then divided equally into two groups. Group A, as the intervention group, received pulsed dye laser (PDL) followed immediately by I/L TA (40 mg/mL). The dose was adjusted in later sessions when needed. Group B, as the control group, received I/L TA  only. All injections were given intradermally using a 30-gauge needle with a 1 mL insulin syringe. Patients were assessed at baseline and at 4, 8, and 12 weeks. Finally, evaluation was done using the Vancouver Scar Scale (VSS) and quartile grading scale. 
Results: Both treatment approaches were effective in reducing keloid size and improving scar characteristics. But Group A showed a more rapid and significant reduction in keloid volume and VSS scores compared to Group B. At 12 weeks, the mean VSS scores were significantly lower in the intervention group than in the control group (p<0.05). 
Conclusion: PDL followed by I/L TA injection demonstrates greater efficacy than steroid injection alone, with favorable clinical outcomes. This combination may be considered more effective for keloid management. 

Bangladesh Armed Forces Med J Vol 59 No (1) June 2026, pp 83-91