ABSTRACT
While the conventional CO2 laser has been used to treat acne scarring in the past, the Ultra-PulseR CO2 laser is now a much safer and effective tool for improving the appearance of surgical, traumatic, and acne scars. It may also have a role in the resurfacing of some hypertrophic scars and in flaps or grafts that have pin-cushioned. The precise control and hemostasis of the laser make it technically easier to use when compared to dermabrasion. History and examination of the patient should address the duration of the scarring, mechanism of injury, and any previous treatments. It should also evaluate for an active or previous herpes simplex infection. No resurfacing should be performed while there is an active infection, herpetic or otherwise, on the skin. Prophylactic antiviral medication is advised if there is a history of herpes simplex eruptions. One regimen is Famciclovir 500mg b.i.d. for one week, or Valcyclovir 125mg b.i.d. for one week, starting either the day before or the morning of the procedure. Preoperative photographs should also be taken and are useful to demonstrate the results to the patient, as well as to provide good documentation.
