This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
Smith et al report their experience with an interesting ultrashort-pulsed, high-powered carbon dioxide laser. This pulsed carbon dioxide laser has the capability of vaporizing tissue and leaving very little thermal damage. It appears from their data that 2 passes of the laser will vaporize through the epidermis and a third pass will then vaporize into the dermis, leaving approximately 100 μm of residual thermal damage. Their statement that in treated pigs the clinical erythema lasted only a few days is consistent with the fact that there was little residual thermal damage underlying this layer of thermal necrosis.
However, their argument that clinical tightening of sagging skin in patients treated with pulsed carbon dioxide lasers occurs simply by an increase in stromal cells and new collagen in the papillary dermis is not supported by any of the data they present and is merely a hypothesis that requires further evaluation
Fitzpatrick RL, Goldman MP. Additonal Observations Using a Pulsed Carbon Dioxide Laser With a Fixed Pulse Duration-Reply. Arch Dermatol. 1997;133(1):107. doi:10.1001/archderm.1997.03890370117024