Side Effects and Complications of Fractional Laser Photothermolysis: Experience with 961 Treatments

BACKGROUND A novel 1,550-nm erbium-doped laser (Fraxel, Reliant Technologies Inc.) has been shown to be effective in the treatment of photodamaged skin and scars with minimal postoperative recovery; however, studies evaluating its side effects and complication rates have been limited. PURPOSE The purpose was to determine the frequency and range of side effects and complications associated with fractional photothermolysis treatment. METHODS A retrospective evaluation of 961 successive 1,550-nm erbium-doped laser treatments in patients of various skin phototypes (I–V) was conducted in a single center. Side effects and complications of treatment, including time of onset and duration, were identified and tabulated. Patient demographics and laser parameters were also assessed. RESULTS Seventy-three treatments (7.6%) resulted in development of complications. The most frequent complications were acneiform eruptions (1.87%) and herpes simplex virus outbreaks (1.77%). Side effects and complications were equally distributed across different ages, skin types, body locations, laser parameters, and underlying skin conditions, except for postinflammatory hyperpigmentation, which occurred with increased frequency in patients with darker skin phototypes. CONCLUSIONS Fractional laser skin treatment is associated with a relatively low complication rate. Side effects and complications observed in this study were temporary and did not result in long-term or significantly severe sequelae (e.g., scarring).

[1]  T. Alster.  Complications of Carbon Dioxide Laser Resurfacing. An Evaluation of 500 Patients , 1998, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[2]  E. Tanzi,et al.  Single‐Pass Carbon Dioxide Versus Multiple‐Pass Er: YAG Laser Skin Resurfacing A Comparison of Postoperative Wound Healing and Side‐Effect Rates , 2003, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[3]  E. Tanzi,et al.  Side effects and complications of variable-pulsed erbium:yttrium-aluminum-garnet laser skin resurfacing: extended experience with 50 patients. , 2003, Plastic and reconstructive surgery.

[4]  R. Anderson,et al.  Fractional Photothermolysis: A New Concept for Cutaneous Remodeling Using Microscopic Patterns of Thermal Injury , 2004, Lasers in surgery and medicine.

[5]  R. Geronemus,et al.  Short-term side effects of fractional photothermolysis. , 2006, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[6]  M. Gold,et al.  Prospective clinical evaluation of 1440-nm laser delivered by microarray for treatment of photoaging and scars. , 2006, Journal of drugs in dermatology : JDD.

[7]  P. Friedman,et al.  Fractional photothermolysis for the treatment of surgical scars: A case report , 2006, Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology.

[8]  R. Geronemus.  Fractional photothermolysis: Current and future applications , 2006, Lasers in surgery and medicine.

[9]  H. Laubach,et al.  Skin responses to fractional photothermolysis , 2006, Lasers in surgery and medicine.

[10]  E. Tanzi,et al.  Fractional Photothermolysis: Treatment of Facial and Nonfacial Cutaneous Photodamage with a 1,550‐nm Erbium‐Doped Fiber Laser , 2007, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[11]  E. Tanzi,et al.  The Use of Fractional Laser Photothermolysis for the Treatment of Atrophic Scars , 2007, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].