The adverse events of deep fractional CO(2): a retrospective study of 490 treatments in 374 patients.

BACKGROUND: Fractionated carbon dioxide CO(2) laser resurfacing unites the idea of fractional photothermolysis with an ablative 10,600-nm wavelength. This technology permits effective treatment of deeper rhytides, photodamaged skin, and scars, with shorter recovery and a decreased side effect profile as compared to traditional CO(2) laser resurfacing.

OBJECTIVES: To study the rate of the adverse events associated with the use of deep fractional CO(2) laser.

METHODS: A retrospective study of 490 fractionated CO(2) laser treatments in 374 patients by ten physicians within one practice was performed between March 3, 2008 and July 28, 2010. Treatment areas included the face, neck, chest, hands, back, and abdomen.

RESULTS: Of the 490 treatments, 365 were of both superficial and deep fractional treatments while 125 treatments were deep. Patients treated were of Fitzpatrick skin types I-IV. Four hundred ninety treatments resulted in 67 adverse events (13.6%) in 63 patients (16.8%), the most frequent adverse events were acneiform eruption (5.3%), herpes simplex outbreak (2.2%), bacterial infections (1.8%), yeast infections (1.2%), hyperpigmentation (1.2%), prolonged erythema beyond 1 month (0.8%), and (0.8%) contact dermatitis. There were no reports of scarring or hypopigmentation.

CONCLUSIONS: Fractional deep CO(2) laser is a safe method for treating rhytides, photodamaged skin, and scars with a low incidence of adverse events.