A study of fractional CO2 laser resurfacing: the best fluences through a clinical, histological, and ultrastructural evaluation

Background Fractional resurfacing is a laser treatment modality to create numerous microscopic thermal injury zones of controlled width, depth, and density that are surrounded by a reservoir of spared epidermal and dermal tissue, allowing rapid repair of laser-induced thermal injury. Objective To evaluate the safety and efficacy of a fractional CO 2 laser system in the treatment of photo-damaged skin with clinical, histological, and ultrastructural evaluation, with special attention to one of the parameters of this laser system: the fluences. Materials and methods Twelve patients with Fitzpatrick skin types II to III with photo-damage skin underwent fractional laser treatment with one single-pass superficial on the face and forearm. Clinical outcome and histological and ultrastructural changes were assessed. Results Light microscopy of biopsies gave important information about skin changes at three different times after fractional treatment, especially revealing some differences between the fluences used in the three groups of patients. Conclusion Fractional resurfacing offers significant surgical advantages allowing to achieve excellent esthetic results in balance with the biological structure. Besides, our study shows already that with 2.07 and 2.77J/cm 2, instead of 4.15J/cm 2, it is possible to reach a biological response without scar formation. © 2011 Wiley Periodicals, Inc.