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Jenny Cotton, PhD; Antoinette F. Hood, MD; Rene Gonin, PhD; William H. Beeson, MD; C. William Hanke, MD

Arch Dermatol. 1996;132(4):425-428.

Abstract
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)

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