Retrospective Study on Effectiveness of 1064 nm Long-pulsed Neodymium-doped: Yttrium–Aluminum–Garnet Laser and 585 nm Semiconductor Solid-state Laser in Keloids

Background: Keloids are benign fibroproliferative lesions characterized by excessive collagen deposition, with unpredictable growth and high recurrence rates. Laser therapy has emerged as a promising option, but comparative data on different laser modalities remain limited, particularly in darker skin types. Aim: The aim of this study was to evaluate and compare the efficacy of the 1064 nm long-pulsed (LP) neodymium-doped: yttrium–aluminum–garnet (Nd:YAG) laser and the 585 nm solid-state semiconductor laser in the treatment of keloids. Materials and Methods: A retrospective study was conducted from January 2024 to January 2025. Treatment-naïve patients with keloids were included and divided into two groups: one treated with the 1064 nm LP-Nd:YAG laser and the other with the 585 nm solid-state laser. Clinical improvement, reduction in pigmentation, visible thickness, and relapse rates were assessed over multiple sessions. Results: A total of 36 patients were included (21 in the 1064 nm group and 15 in the 585 nm group). Over 70% of patients in both the groups showed clinical improvement. The 1064 nm laser was more effective for thick, fibrotic keloids, while the 585 nm laser showed superior results in erythematous, vascular lesions. No significant adverse effects were observed. Conclusion: Both laser modalities demonstrated effectiveness in keloid management. The 1064 nm laser is preferable for fibrotic lesions, whereas the 585 nm laser offers better outcomes for vascular keloids. Individualized, morphology-based laser selection is essential for optimizing treatment results in patients with Fitzpatrick type IV skin.