Laser Carbon Dioxide Resurfacing

Excerpt

Carbon dioxide (CO2) lasers have been in use since the 1960s; they were initially used primarily for cutting and destruction of tissue, employing a continuous wave mode that ablates tissue to a depth of 400-500 μM. This modality was used across a broad range of clinical applications, such as the treatment of cervical intraepithelial neoplasia and upper eyelid blepharoplasty. In the 1990s, CO2 laser technology evolved, resulting in high-energy pulsed CO2 lasers that ablate tissue at a more superficial depth, between 20 and 100 μM, while minimizing thermal injury to deeper tissue. These high-energy pulsed CO2 lasers are particularly useful for less aggressive applications, including cutaneous resurfacing. Further advancing the state of the art, fractional CO2 laser delivery systems were subsequently introduced in 2004. Fractional treatment involves splitting the laser beam into a large number of microbeams, which creates columns of ablation through the skin surrounded by normal, undamaged tissue. This treatment modality may provide an improved side effect profile compared with non-fractional treatment, particularly with respect to avoiding dyspigmentation after treating patients with darker skin.