LAUSR

Dear Editor, Hypertrophic and keloid scars result from an abnormal hyperproliferation of dermal fibroblasts with increased depositions of collagen in the wound and, in keloids, an expansion beyond the boundaries of the initial insult. In this imbalance favoring collagen production over matrix degradation, transforming growth factor-β1 and 2, vascular endothelial growth factor, and inhibition of proapoptotic p53 genes are playing key roles (Alexandrescu, Fabi, Yeh, Fitzpatrick, & Goldman, 2016). By modulating the activities of the aforementioned factors, corticosteroids, both topical and injected, are one of the most prescribed treatment despite a limited effectiveness, a high recurrence rate, and even rare exacerbations (Cavalié et al., 2015). To overpass the stratum corneum and its barrier properties, ablative fractional lasers (AFL) can create vertical channels to enhance topical drug delivery deep into the dermis (Cavalié et al., 2015). In this way, laser-assisted corticosteroid delivery (LACD) can be an alternative or a complementary treatment to intralesional injections of steroids (ILIS).