Overview
Older wrinkle treatments were limited by scarring and pigment changes in delicate facial skin. The authors treated 259 patients with a high-energy pulsed CO2 laser. Two blinded assessors rated results at 1, 4, 8, 12 and 24 weeks.
Findings
- 259 patients with facial wrinkles: 104 around the mouth, 83 around the eyes, 53 between the brows, 17 on the forehead.
- Blinded evaluation by two assessors at 1, 4, 8, 12 and 24 weeks.
- Average improvement across all areas: 90%.
- Best response around the eyes: average 93% improvement.
- Lowest response (86.8%): the most severe wrinkles and those caused by strong muscle movement, such as frown lines between the brows.
- No scarring.
- Redness lasting 1 to 3 months (mean 2.2 months) was typical.
- Temporary postinflammatory hyperpigmentation, averaging 3 months, in 30% of patients, not limited to darker skin.
- Treatment was outpatient without general anesthesia.
What it means for a patient
- Wrinkles around the eyes responded best; frown lines and the deepest wrinkles responded least.
- Expect redness for about 2 months and possible temporary darkening of the skin, which occurred in 30% of patients.
- No scarring occurred in this series.
- Follow-up was 24 weeks. The authors state that evidence for long-lasting results was preliminary.
Why this paper matters
It reported results by facial area and side effects in a large group treated with a high-energy pulsed CO2 laser. The authors conclude it is safe and effective for facial wrinkles in an outpatient setting. Cited 145 times (NIH iCite, 2026-09-25).
Terms
- Rhytides: wrinkles.
- CO2 laser resurfacing: a laser treatment that removes thin layers of skin so new skin grows.
- High-energy pulsed laser: a laser that delivers short, strong bursts to limit heat damage to nearby skin.
- Perioral: around the mouth.
- Periorbital: around the eyes.
- Glabellar: the area between the eyebrows.
- Erythema: redness of the skin.
- Postinflammatory hyperpigmentation: darkening of the skin after injury or inflammation.