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June 19, 1996


Author Affiliations

New England Deaconess Hospital and Harvard Medical School, Boston, Mass; Beth Israel Hospital and Harvard Medical School, Boston, Mass

JAMA. 1996;275(23):1801-1802. doi:10.1001/jama.1996.03530470029017

Altering the texture and surface characteristics of the skin to correct scarring caused by such disorders as acne or varicella, or to eliminate the aged-skin appearance associated with chronic photodamage, has long been a topic of great interest to cutaneous surgeons. Considerable success can be achieved by chemical (acid peels), physical (dermabrasion), or thermal (continuous-wave carbon dioxide [CO2] laser) techniques, but all methods have deficiencies and associated risks.1-3 The development of pulsed and scanned CO2 lasers has initiated a revolution in aesthetic skin surgery in the past year.4-6 [See also Plastic Surgery.— Ed. When continuous-wave CO2 lasers vaporize tissue, they leave behind a zone of thermal damage of between 200 and 600 μm.

Dwelling too long on a specific area leads to substantial thermal diffusion, excessive thermal damage, and resultant scarring. Pulsed CO2 lasers can selectively vaporize thin layers of tissue, leaving behind a