Overview
CO2 laser resurfacing had become popular, but written data on its complication rates were scarce. The authors reviewed the charts of 500 consecutive patients who had 1,589 facial areas treated with the UltraPulse CO2 laser by one operator. They recorded infection, healing problems, pigment changes and scarring.
Findings
- 500 consecutive patients; 1,589 facial regions; UltraPulse CO2 laser; single operator; retrospective chart review.
- Redness (erythema) after treatment: all patients; average duration 4.5 months.
- Hyperpigmentation: 37% of patients, higher in darker skin types.
- Acne flares, milia and dermatitis: 10% to 15% of patients.
- Herpes simplex virus infection after treatment: 7.4%, regardless of prior herpes history.
- Hypopigmentation, scarring and other local or spread infections: under 1%.
What it means for a patient
- If you plan CO2 laser resurfacing of the face, expect redness for months. In this study it lasted 4.5 months on average.
- Darker skin types had a higher rate of skin darkening after treatment.
- Herpes outbreaks occurred even in patients with no history of cold sores. Ask whether you will receive preventive medicine.
- Serious problems such as scarring and light patches of skin occurred in under 1%.
- These are one operator's results with one laser model; results with other lasers or settings may differ.
Why this paper matters
It gave complication rates for CO2 laser resurfacing from a large consecutive series. The authors conclude the procedure is relatively safe and that treatment protocol and aftercare matter for reducing side effects. Cited 341 times (NIH iCite, 2026-09-25).
Terms
- CO2 laser resurfacing: a laser treatment that removes thin layers of skin so new skin grows.
- Erythema: redness of the skin.
- Hyperpigmentation: darkening of the skin.
- Hypopigmentation: lightening of the skin.
- Milia: small white cysts under the skin surface.
- Dermatitis: skin inflammation or rash.
- Herpes simplex virus (HSV): the virus that causes cold sores.
- Skin phototype: a scale of skin color and how skin reacts to sun.