Efficacy and Mechanistic Insights into Indocyanine Green Photodynamic Therapy for Postoperative Keloids

Our study evaluated the efficacy of surgery combined with indocyanine green (ICG) photodynamic therapy for keloids and explored its mechanisms through in vitro experiments. Patients with refractory keloids were randomized into a control group (surgery + corticosteroid injections) and a treatment group (additional ICG photodynamic therapy). Follow-ups were conducted over one year. ICG photodynamic therapy effectively reduced keloid recurrence with high safety and tolerability but limited efficacy. In vitro , keloid fibroblasts were treated with ICG photodynamic therapy to assess viability, migration, apoptosis, autophagy, and collagen formation. Photodynamic effects alone showed significant inhibition of cell viability, promotion of apoptosis and autophagy, and suppression of collagen formation at low drug concentrations. This informed an optimized clinical protocol that achieved improved outcomes, although further validation in controlled studies is required.