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April 1996

Histologic Evaluation of Preauricular and Postauricular Human Skin After High-Energy, Short-Pulse Carbon Dioxide Laser

Arch Dermatol. 1996;132(4):425-428. doi:10.1001/archderm.1996.03890280087012

Background:  Despite its growing use in dermatologic surgery, the effects of the high-energy, short-pulse carbon dioxide laser on human skin have not been well documented.

Objectives:  To study the histologic effects of this high-energy, short-pulse CO2 laser on human skin and to compare these changes with the effects of standard chemexfoliation procedures.

Observations:  Twenty-four hours after laser administration, there was extensive epidermal necrosis and coagulative change in the superficial papillary dermis. With increasing doses of laser energy, there was a statistically significant increase in the depth of dermal wounding (P<.001 for days 1 and 3, F-test). Reepithelialization occurred in most specimens by day 3. By day 90, most specimens showed a subepidermal dermal repair zone consisting of compact new collagen fibers overlying collagen with evidence of solar elastosis.

Conclusions:  This high-energy, short-pulse CO2 laser produces morphologic changes similar to those seen with medium-depth chemical peels. This laser can ablate skin precisely and bloodlessly with little interference in the wound healing process, suggesting that it may serve as an alternative treatment for photoaged skin.(Arch Dermatol. 1996;132:425-428)