CO2 laser resurfacing: still a good treatment.

Aesthet Surg J. 2008 Jul-Aug; 28(4): 456-62Sandel HD, Perkins SWThe authors recommend carbon dioxide (CO(2)) laser resurfacing as an excellent tool for treatment of aging skin, especially when used for moderate to severe facial rhytids, explaining that some of the commonly cited disadvantages of this modality can be avoided with proper patient selection and conservative treatment settings. They contend that the ability to control fluence, density, and pattern size provides an excellent benefit-risk ratio. In addition, using a combination of other resurfacing modalities, such as 35% trichloroacetic acid chemical peels, 88% phenol, and dermabrasion with the CO(2) laser produces outstanding results. They cite their experience in safely and effectively performing simultaneous rhytidectomy and CO(2) laser resurfacing. Although newer technologies exist with less potential complications and downtime than the CO(2) laser, the authors point out that these modalities require multiple treatments, each with its own downtime, at a higher overall cost and with results that are arguably inferior. Here, they discuss their experience and techniques using the CO(2) laser, considering efficacy when used alone and in combination resurfacing treatments, and discuss its histology, physics, and history.