DOI: http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20194657

Complications of fractional ablative carbon dioxide laser in various aesthetic procedures: a retrospective study

Jasleen Kaur, Saurabh Sharma, Tanreet Kaur, Roopam Bassi

Abstract


Background: Though fractionated CO2 laser technology resurface patients with a lower rate of complications than non-fractionated ablative laser treatment, adverse effects can still occur even with the best technology.

Methods: In this retrospective study we evaluated 65 patients for early and delayed complications after laser treatment with Sellas Cis-Fl™ fractional CO2 laser system of wavelength 106400 nm for various aesthetic indications over the period of 12 months from October 2017 to September 2018. Follow up was done for the period of 2 months after the last session to determine the nature and frequency of various complications. Patient’s subjective assessment of the complications was recorded in the form of patient subjective score (PSS) which ranged from 1 to 10.

Results: In the current study, the most common aesthetic indication for fractional CO2 laser was post acne scarring (38.4%). The most common early side effects reported were erythema (95.38%) and burning sensation (92.30%) after the procedure. Post procedural dryness and edema was seen in 72.3% and 69.23% patients. Among the delayed complications most frequently observed was persistent erythema (46.15%) followed by post inflammatory hyperpigmentation (44.61%).

Conclusions: Though fractional CO2 laser is relatively a safe procedure, undesirable sequelae may still occur as a result of inappropriate selection of laser parameter, injudicious patient selection, inadequate preoperative counselling and suboptimal postoperative care. Dermatologist should keep the possibility of all the side effects that can occur after fractional CO2 laser and must take appropriate precautions during the procedure to avoid them.


Keywords


Microthermal zones, Fractional lasers, Ablative lasers

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References


Manstein D, Herron GS, Sink RK, Tanner H, Anderson RR. Fractional photothermolysis: A new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med. 2004;34(5):426-38.

Manuskiatti W, Triwongwaranat D, Varothai S, Eimpunth S, Wanitphakdeedecha R. Efficacy and safety of a carbon-dioxide ablative fractional resurfacing device for treatment of atrophic acne scars in Asians. J Am Acad Dermatol. 2010;63(2):274-83.

Tanzi EL, Alster TS. Single‐pass carbon dioxide versus multiple‐pass Er: YAG laser skin resurfacing: A comparison of postoperative wound healing and side‐effect rates. Dermatol Surg. 2003;29(1):80-4.

Rendon‐Pellerano MI, Lentini J, Eaglstein WE, Kirsner RS, Hanft K, Pardo RJ. Laser resurfacing: usual and unusual complications. Dermatol Surg. 1999;25(5):360-7.

Metelitsa AI, Alster TS. Fractionated laser skin resurfacing treatment complications: a review. Dermatol Surg. 2010;36(3):299-306.

Kono T, Chan HH, Groff WF, Manstein D, Sakurai H, Takeuchi M, et al. Prospective direct comparison study of fractional resurfacing using different fluences and densities for skin rejuvenation in Asians. Laser Surg Med. 2007;39(4):311-4.

Zhang AY, Obagi S. Diagnosis and management of skin resurfacing– related complications. Oral Maxillofac Surg Clin North Am. 2009;21(1):1-12.

He SY, McCulloch CE, Boscardin WJ, Chren MM, Linos E, Arron ST. Selfreported pigmentary phenotypes and race are significant but incomplete predictors of Fitzpatrick skin phototype in an ethnically diverse population. J Am Acad Dermatol. 2014;71(4):731-7.

Kim YJ, Lee HS, Son SW, Kim SN, Kye YC. Analysis of hyperpigmentation and hypopigmentation after Er: YAG laser skin resurfacing. Lasers Surg Med. 2005;36(1):47-51.

Alster TS, West TB. Resurfacing of atrophic facial acne scars with a high‐energy, pulsed carbon dioxide laser. Dermatol Surg. 1996;22(2):151-5.

Setyadi HG, Jacobs AA, Markus RF. Infectious complications after nonablative fractional resurfacing treatment. Dermatol Surg. 2008;34(11):1595-8.

Alam M, Pantanowitz L, Harton AM, Arndt KA, Dover JS. A prospective trial of fungal colonization after laser resurfacing of the face: correlation 134 between culture positivity and symptoms of pruritus. Dermatol Surg. 2003;29(3):255-60.

Graber EM, Tanzi EL, Alster TS. Side effects and complications of fractional laser photothermolysis: experience with 961 treatments. Dermatol Surg. 2008;34(3):301-7.

Griffin AC. Laser resurfacing procedures in dark-skinned patients. Aesthet Surg J. 2005;25(6):625-7.

Kim BJ, Lee DH, Kim MN, Song KY, Cho WI, Lee CK, et al. Fractional photothermolysis for the treatment of striae distensae in Asian skin. Am J Clin Dermatol. 2008;9:33-7.