A prospective study of fractional scanned nonsequential carbon dioxide laser resurfacing: a clinical and histopathologic evaluation.

Background: Although unparalleled in its efficacy, carbon dioxide (CO2) laser resurfacing has a high risk:benefit ratio. A modified device uses a novel handpiece and software to deliver nonsequential fractional ablative CO2 laser exposures.

Objective: To evaluate the safety and efficacy of this fractional ablative, scanned, nonsequential CO2 laser in the treatment of photo-damaged skin and to evaluate histologic and ultrastructural changes after the treatment.

Materials And Methods: Ten subjects with Fitzpatrick skin types I to III with photo-damaged facial skin underwent a single CO2 ablative laser treatment using a scanning handpiece in a nonsequential fractional mode. Clinical improvement and histologic and ultrastructrural changes were assessed.

Results: All subjects completed the study with no serious or long-term complications. Blinded evaluator and subject assessment documented improvement in cutaneous photoaging. Light microscopy revealed changes consistent with a wound repair mechanism, and electron microscopy confirmed evidence of new collagen deposition.

Conclusion: Nonsequential scanned fractional CO2 laser resurfacing can lead to improvement in photo-damaged skin, accompanied by histologic and ultrastructural evidence of wound repair and subsequent new collagen formation.