ABSTRACT
BACKGROUND The development of fractional photothermolysis is one of the most important discoveries in the ‘eld of laser medicine and surgery. This concept has revolutionized laser skin resurfacing. Previously patients could only signi‘cantly enhance their skin through fully ablative lasers, like the 10,600-nm carbon dioxide (CO2) or the 2940-nm erbium-doped yttrium aluminum garnet (Er:YAG) lasers. These laser treatments required at least 1 to 2 weeks of recovery depending on the depth of resurfacing and the type of laser utilized. With deeper resurfacing procedures, patients could experience considerable discomfort and side effects. Results could be exceptional but patients soon became aware of the potential disadvantages of aggressive procedures. Besides the potential side effects of infection or permanent scarring, many patients who were treated with deep CO2 laser resurfacing experienced prolonged erythema of the skin for 6 months to a year. Many also developed unexpected permanent hypopigmentation of their treated skin (1,2). In addition, patients also became aware of the stark contrast between their beautiful resurfaced facial skin, which was now adjacent to their severely sun-damaged neck and chest. Fully ablative laser resurfacing was fraught with severe complications when used off the face. Darker skin types were not candidates for the procedure. With these limitations, traditional deep ablative resurfacing began to decrease in popularity.
