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Objectives: To compare the efficacy of fractional CO2 laser assisted delivery of either triamcinolone or 5fluorouracil in the treatment of keloids To review the literature on laser assisted delivery of triamcinolone and fluorouracil in the treatment of keloids Introduction: Keloids are one of the most dreaded sequelae of acne. They can be symptomatic with pruritus and pain, and can cause significant disfigurement, leading to psychological distress and impacting the quality of life. They are notoriously difficult to treat, as most treatment modalities have limited effectiveness and have adverse reactions. Moreover, they have a tendency to recur, leading to frustration for both patients and clinicians. Research into more effective treatments is therefore essential to improve outcomes for this challenging condition. Materials / method: This was a hospital based prospective, double blind, randomized controlled trial of 20 patients with chest keloids. They were randomly assigned to receive fractional laser assisted drug (LADD) delivery with either triamcinolone 10mg/ml solution or 50mg/ml 5 fluorouracil (5fu) solution. Treatments and monitoring of outcome measures were done monthly for 6 months. Outcome measures were lesion size, Vancouver Scar Scale (VSS) score, Patient and Observer Scar Assesment Scale (POSAS) scale and photography. Adverse events were noted. Results: Both treatment arms reduced the keloids’ overall surface area. There was no statistical difference between the two groups. There was more pain and erythema noted in the 5fu while telangiectasia and pruritus were more prominent in the triamcinolone group Conclusion: Laser assisted drug delivery offers a potential alternative treatment for keloids by improving drug penetration and efficacy. Triamcinolone and 5fu are equally effective in reducing lesion size.