Risks from Ablative CO2 Laser Resurfacing?

One of the biggest advantages of the new, more sophisticated CO2 lasers is the significant decrease in side effects when compared to older lasers and older techniques. CO2 resurfacing has been around for a long time, but initially the lasers or much more limited with respect to the control that you had over them, and the treatment area was continuous without any islands of normal skin left in between to expedite healing.The most publicized side effect of CO2 resurfacing was hypopigmentation, which did tend to happen in a continuous fashion, not being broken up, and giving the entire treated area a lighter appearance. This was sometimes desirable, but often left A line of delineation between treated and untreated areas.New her CO2 lasers are significantly more sophisticated and allow your laser surgeon to carefully choose parameters and control them very closely. This allows your treatment to be tailored exactly to your needs, maximizing your benefits and minimizing your side effects. This is where all laser surgeons are not created equal.In addition to increased control, most of the new CO2 lasers have the capacity to fractionate your treatment. What that means is instead of treating the entire surface of the skin, small zones of skin are ablated, leaving normal islands of skin and between intact. This allows you to heal quickly and significantly decreases the side effects while still providing the overall capacity for your desired results to be obtained.In addition to hypopigmentation, scarring was always a theoretical risk, as well as prolonged redness. Even with fractionated lasers this redness can last 2 to 4 weeks in a normal situation, but when persisting longer is considered to be prolonged redness.CO2 resurfacing can get beautiful, dramatic results at a very reasonable price. As I said though, not all laser surgeons are created equal. To guarantee you're receiving the highest level of care, seek out a dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties.

Ablative resurfacing is an intense treatment that does have certain risks linked to the procedure. Both hypopigmentation and hyperpigmentation are two of those risks, particularly when treating certain skin tones. However, when this device is used by a very experienced, board-certified dermatologist with expertise in this procedure, the risks are greatly reduced. My advice is to make sure the doctor you choose has the qualifications and experience necessary to ensure a safe and successful treatment.

Thank you for your question. It is common to have hyperpigmentation or even hypopigmentation after an ablative laser. I always recommend to pretreat with a lightening cream such as hydroquinone 2 weeks prior to the procedure to reduce the risk of hypo/hyper pigmentation.

Thanks for the great question.  With nonfractional deep ablative resurfacing (i.e. fully ablative laser) there is a risk of hypopigmentation.  However this was more common with the first generation CO2 fully ablative lasers.  Newer CO2 lasers are more precise and are lower risk.  Furthermore, with fractional ablative resurfacing hypopigmentation is much less common and if it does occur it is usually only temporary.  This is the beauty of fractional technology because islands of normal skin are preserved between the ablated tissue. This allows quicker recovery and collagen remodelling with less risks.    The Lumenis Ultrapulse TotalFX laser achieves excellent results with this technology.
Hope that this helps.  A consultation with a board certified dermatologist with training in laser and cosmetic surgery is recommended.

Skin darkening (hyper-pigmentation) of the skin can occur in the treated area and will eventually fade within a few months This reaction is more common in patients with olive or dark skin tones.  The risks of this complication are minimal but can occur.

Many years ago, full C02 laser ablation was utilized a lot. But we were seeing a lot of side effects like scarring, pigmentation issues, persistent redness, and a marble like quality to the skin. Now with fractional laser ablation technology- resurfacing can be performed in a much more safer way. In my practice, we utilize fractional laser resurfacing for its safety and efficacy.