CO2 laser still useful

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CO2 laser still useful
Dec 1, 2007
Bill Gillette
Dermatology Times

National report Û The popularity of CO2 laser devices for full-face dermabrasion treatment may have come to an end, but such devices can still be effective for certain scar dermabrasion procedures Û at least according to one dermatologist.

"In my opinion, CO2 lasers have lost their utility for full-face treatments, but I still find it useful for scar dermabrasions," says Joel Schlessinger, M.D., director of Skin Specialists P.C., Omaha, Neb., and outgoing president of the American Society of Cosmetic Dermatology & Aesthetic Surgery.

Dr.Goldberg

"Patients had to go through significant recovery times in full-face dermabrasion treatments, and this has led to the migration away from C02 lasers for that procedure.

"Five years ago," he adds, "I would have said that CO2 lasers' usefulness would certainly have continued, and, in my opinion, nothing has come around yet that is as good as the CO2 laser for scar dermabrasions. But other, more sophisticated laser devices have taken its place in full-face procedures."

David J. Goldberg, M.D., agrees with Dr. Schlessinger's assessment of CO2 lasers' usefulness for full-face dermabrasion.

"Standard CO2 lasers are generally not used for this anymore," says Dr. Goldberg, director of Skin Laser & Surgery Specialists of New York/New Jersey, and clinical professor of dermatology at New York's Mount Sinai School of Medicine.

"It was a very popular procedure 10 years ago, but grew out of favor because there was a seven- to 14-day period of downtime with an unacceptably high risk of complications, unless performed by an experienced laser expert."

Difference of opinion

However, Dr. Goldberg does not agree that CO2 lasers remain the treatment of choice for scar dermabrasions.

"Five years ago, nonablative 'lunchtime' laser procedures were shown to produce mild improvement without significant downtime and without high risk," he says.

"Better results bordering on those of old-fashioned CO2 lasers can be seen with today's popular fractional lasers, such as Fraxel (Reliant), StarLux (Palomar) and Affirm (Cynosure) lasers."

Dr. Goldberg says the latest and best approach appears to be from fractional CO2 lasers. He says his practice's research unit recently completed one of the first studies on this fractional CO2 laser device.

"Results with the fractional CO2 laser devices are better than those seen with the popular fractional lasers such as Fraxel, StarLux and Affirm," Dr. Goldberg tells Dermatology Times, "but they do require a long weekend of downtime."

Dr. Schlessinger adds that in addition to the relatively significant downtime, there are still some risks of infection and pigmentation changes with the fractional CO2 devices.

As for what the future may hold for improving the appearance of scars, Dr. Schlessinger says there are some unique options to laser treatment.

"These therapies have to do with the growth and replacement of skin cells, but nothing can be reported as yet," he says. "These options are still being developed and tested."