Can facial lasers cause keloids?

Keloids are a subset of scars that are often confused and used interchangeably with other scar types such as hypertrophic scars, widened/atrophic scars and so on. This is so even amongst medical doctors. However, they are vastly different in terms of aetiology, histology, treatment and evolution.

Keloids can arise from any form of trauma to the skin, even minor or blunt trauma. There is a genetic/racial predisposition to this and should you have had keloids from previous injuries, then you are at higher risk. As mentioned, lasers, whether ablative or non-ablative can possibly result in keloids; only the risk level differs.

What is more important is that the physician performing the laser is fully aware of your medical history prior to commencement. For e.g., patients who have been on isotretinoin therapy (Accutane etc) should not have any form of ablative laser treatment, whether fractionated or otherwise, for at least 6 months after cessation of isotretinoin therapy. These patients are at a high risk of scarring and keloid formation.

That really depends on what sort of lasers/skin treatments you are doing. Ablative lasers, deep chemical peels or skin devices like fractional RF breach the skin layer and pose a risk for keloid formation.

This is why I personally have both ablative and non-ablative fractional lasers for scar/rejuvenation/wrinkle treatments.

If you are only using non-ablative lasers or laser toning, there is negligible risk.

In fact, some non-ablative lasers like the pulsed-dye or long pulsed ND:Yag lasers can be useful for treating keloids!

Unfortunately anything that breaches the skin, including fractional lasers (which really depends on the degree of injury induced by the laser settings) has a risk of keloid formation.

It is hard to ascertain if it will occur, but you might want to discuss with your doctor on the various modalities. As Dr Chua mentioned, non-ablative lasers can be useful in solving your skin concerns too!