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Suzanne L. Kilmer, MD; Vera Chotzen, MD; Brian D. Zelickson, MD; Marla McClaren, MD; Susan Silva, MD; Jacqueline Calkin, MD; David No, MD, PhD

Arch Dermatol. 2003;139:1279-1283.

Background  Laser resurfacing has become a popular modality for the treatment of photodamaged skin, rhytids, and acne scarring. In many cases, this procedure is performed under general anesthesia or intravenous sedation in conjunction with nerve blocks and local infiltration.

Objective  To evaluate the safety and efficacy of facial carbon dioxide laser resurfacing using a supplemented topical anesthesia protocol.

Design  Nonrandomized case series of patients observed for 1 year.

Setting  Outpatient surgery center.

Patients  Two hundred consecutive patients undergoing treatment for facial rhytids or acne scarring.

Intervention  Full-face carbon dioxide laser resurfacing procedures were performed using a supplemented topical anesthesia protocol. Pretreatment medications included diazepam, oral analgesics, and intramuscular ketorolac tromethamine.

Main Outcome Measures  Tolerability of procedure, healing times, and adverse effects.

Results  Topical anesthesia provided effective and sufficient anesthesia in most cases. Only 10 of 200 patients required additional anesthesia (regional nerve blocks and/or local infiltration). Substantial improvement of rhytids, photodamage, and acne scarring was observed. Posttreatment hypopigmentation was seen in 1 patient. Scarring was not observed.

Conclusion  A supplemented topical anesthesia protocol for full-face laser resurfacing is a safe and effective alternative to traditional anesthesia strategies.

From the Laser & Skin Surgery Center of Northern California, Sacramento. The authors have no relevant financial interest in this article.

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