Can CO2 laser and Microneedling be performed on flattened keloids?

Question

I had some keloid scars on my jawline (caused by cystic acne). About 8 years ago I received treatment with VBeam laser and with kenalog + 5FU injections. My keloid scars flattened, but now I’m interested in CO2 laser and/or microneedling on my full face to improve some atrophic scars and skin texture. Can these be performed over flattened keloids, or are there risks? Can anything be done to mitigate the risks? I would love to smooth the skin on my jawline, if possible.

Mark Beaty, MD · Answer

Yes, both CO₂ laser resurfacing and microneedling can be performed over areas of previously flattened keloid scars. However, because you have a history of keloid formation, there is always a risk that any treatment that creates controlled injury to the skin could potentially stimulate the keloids to recur.

For improving atrophic acne scars and overall skin texture, CO₂ laser resurfacing in combination with RF microneedling can be a powerful treatment approach. The goal, however, should be improvement rather than expecting to completely smooth the skin. With established acne scarring—particularly in an area that has previously formed keloids—it can be difficult to create completely smooth skin.

There isn't a way to completely eliminate the risk of keloid recurrence. You can lower the energy settings on the devices, which may reduce the amount of thermal or mechanical injury, but the trade-off is that you may not achieve as significant a result.

Given your history, I would recommend finding a provider who routinely performs CO₂ laser resurfacing and RF microneedling, particularly in patients with significant scarring. Look for someone with extensive experience and good reviews whose approach you feel comfortable with. A thorough evaluation of your skin and the previously treated keloids would be important before deciding how aggressively to treat the jawline.

Can CO2 laser and Microneedling be performed on flattened keloids?

Answers (1)

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