Efficacy of Laser-Assisted Intralesional Triamcinolone for Pathological Scars

BACKGROUNDPathological scars result from aberrant wound healing and remain challenging to treat. Intralesional triamcinolone acetonide is the current mainstay of therapy. Recently, adjuvant laser therapy has emerged as a promising strategy to enhance drug penetration and modulate scar vasculature and collagen remodeling. This meta-analysis assesses the clinical efficacy of laser-assisted intralesional triamcinolone in the treatment of pathological scars.

METHODSIn March 2026, we conducted a systematic search of PubMed, Scopus, Web of Science, Embase, and the Cochrane Library for randomized controlled trials (RCTs) and non-randomized studies directly assessing laser plus intralesional triamcinolone. For the meta-analysis, we used R 4.5.0 with R Studio 2024.12.1 + 563.

RESULTSOur review included five RCTs and three non-randomized comparative studies. Six studies encompassing 248 patients were included in the meta-analysis. Compared with intralesional triamcinolone alone, laser combination therapy showed no significant difference in VSS/mVSS reduction (SMD = 0.28, 95% CI: −0.53 to 1.10, p = 0.496), with substantial heterogeneity (I2 = 83.1%). However, when compared with laser monotherapy, the combination significantly improved VSS/mVSS (SMD = −1.16, 95% CI: −1.85 to −0.48, p = 0.0008; I2 = 16.9%). Patient satisfaction appeared higher with combination therapy, but certainty was low, and the comparison with laser monotherapy was based on a single study. For VSS subscales vs. laser alone, combination therapy significantly improved vascularity, pliability, and height, but not pigmentation. Recurrence rates did not differ significantly between groups.

CONCLUSIONLaser plus intralesional triamcinolone may improve scar scores and patient satisfaction compared with laser monotherapy, but current evidence does not demonstrate superiority over intralesional triamcinolone alone. Recurrence benefit remains uncertain. However, our findings are limited by the small number of RCTs and substantial heterogeneity. Future adequately powered RCTs with longer follow-up periods are warranted.

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