Laser-induced acoustic shockwave-assisted intralesional triamcinolone injection for keloid: a two-case series

Keloid scars are challenging to treat, often requiring multimodal strategies to achieve meaningful clinical improvement.Recent advances in laser-induced acoustic shockwave systems using diamond-particle-based patches have enabled the noninvasive generation of high-pressure acoustic pulses capable of mechanical tissue disruption similar to subcision.This paper reports two cases of acne-induced keloids successfully treated with a combination of a diamond particle acoustic patch activated by a Q-switched 1,064-nm Nd:YAG laser and an intralesional triamcinolone injection.In both cases, an acoustic shockwave treatment was applied immediately before a corticosteroid injection to soften and mechanically disrupt the fibrotic tissue, and again after injection to enhance intralesional drug dispersion.Both patients showed rapid flattening of their keloids after two sessions, with no complications.These cases highlight the synergistic potential of laser-induced acoustic shockwaves and corticosteroid injections for keloid remodeling.