Overview
Laser resurfacing for wrinkles is effective and relatively safe, and most non-infectious complications can be avoided or managed. Infections can occur even with proper technique. The authors reviewed all patients treated for facial wrinkles with a pulsed CO2 laser from January 1995 to April 1996 to measure how often infection occurred and what caused it.
Findings
- 395 procedures over 16 months; retrospective record review.
- Infection defined as a positive culture plus signs or symptoms.
- 17 culture-proven infections: incidence 4.3%.
- Symptoms began between day 2 and day 10 after surgery in all cases.
- Over half had 2 to 3 organisms at once.
- Organisms: Pseudomonas aeruginosa 41%, Staphylococcus aureus 35%, S. epidermidis 35%, Candida species 24%.
- Multidrug-resistant gram-negative bacteria in 4 cases, suggesting possible hospital-acquired infection.
- Almost all gram-positive bacteria resisted erythromycin and penicillin, but not oxacillin.
- Most patients healed normally with treatment.
- 1 patient had lasting scars from spreading herpes simplex infection despite preventive treatment.
- Infection was much more common with full-face resurfacing and with bio-occlusive dressings.
What it means for a patient
- About 4 in 100 laser resurfacing procedures in this series led to infection, usually showing up 2 to 10 days after treatment.
- Full-face treatment and sealed dressings carried a higher infection risk.
- With early recognition and treatment, most infected patients healed normally.
- Report any sign of infection after resurfacing right away. The authors stress early recognition.
- This is a retrospective review over 16 months.
Why this paper matters
It measured the infection rate after CO2 laser resurfacing and named the organisms involved, which resembled those in burn patients. The authors give prevention and management recommendations. Cited 141 times (NIH iCite, 2026-09-25).
Terms
- CO2 laser resurfacing: a laser treatment that removes thin layers of skin so new skin grows.
- Photoaged skin: skin damaged by sun exposure.
- Culture-proven infection: an infection confirmed by growing the organism in the lab.
- Pseudomonas aeruginosa: a bacterium that often infects burns and moist wounds.
- Candida: a yeast that can cause infection.
- Bio-occlusive dressing: a sealed dressing that keeps the wound moist.
- Prophylaxis: treatment given to prevent infection.
- Multidrug-resistant: not killed by several common antibiotics.