Complications of carbon dioxide laser resurfacing - An evaluation of 500 patients

BACKGROUND. Cutaneous laser resurfacing with high-energy, pulsed and scanned carbon dioxide (CO2) lasers has become popularized for the treatment of a variety of cutaneous indications, but potential complications and side effects remain a large concern. Despite the recent boom in cutaneous laser resurfacing procedures, were remains a relative paucity of written information documenting laser complication rates. OBJECTIVE. We purpose of this study was to identify and report the complications that occurred after cutaneous CO2 laser resurfacing within a large patient population. METHODS. A retrospective analysis and chart review was performed in 500 consecutive patients who underwent cutaneous laser resurfacing of 1589 facial regions with the UltraPulse CO2 laser by a single operator. Side effects and complications relating to infection, postoperative healing, pigmentary changes, and scarring were tabulated. RESULTS. The most common complication observed was post-operative erythema, which occurred in all patients, lasting an average of 4.5 months. Hyperpigmentation was seen in 37% of patients with a higher rate in darker skin phototypes. Acne flares, milia formation, and dermatitis occurred in 10-15% of patients. Postoperative infection with herpes simplex virus (HSV) was observed in 7.4% regardless of prior HSV history. Hypopigmentation, scarring, and other local or disseminated infections occurred in <1% of this study population. CONCLUSIONS. Cutaneous CO2 laser resurfacing is a relatively safe procedure with a low complication profile. Proper laser treatment protocol and postoperative management is important in reducing side effects and complications. (C) 1998 by the American Society for Dermatologic Surgery, Inc.