THE ORIGIN AND ROLE OF ERYTHEMA AFTER CARBON-DIOXIDE LASER RESURFACING - A CLINICAL AND HISTOLOGICAL STUDY

BACKGROUND. Transient erythema, which can last tip to 3 months after c arbon dioxide (CO2) laser skin resurfacing, is a usual side effect wit h pulsed or rapidly scanned CO2 lasers. OBJECTIVE. We evaluated the ca use of erythema in the clinical setting and by histology in order to d etermine if and how we may decrease it, or even eliminate it. METHODS. Ten patients who underwent resurfacing were recruited to this study. Skin punch biopsies were taken at 0, 7, 21, and 90 days and analyzed b y light microscopy. RESULTS. Erythema was noticed from about day 8, wh en the crusting on the skin surface was exfoliated. It reached its max imum intensity after 14 days, and had disappeared by 60-90 days. Histo logy showed an early inflammatory response, with an immature neoepithe lium, and rich vascularization. The normal epidermis had returned by 9 0 days, and during this period there teas reduced optical scattering a nd absorption in melanin. CONCLUSION. Although the erythema is an unwa nted side effect in the patient's eyes, it is to be expected and thus represents the effects of a combination of epidermal immaturity, reduc ed melanin absorption of light, reduced dermal optical scattering, and increased blood flow secondary to the surgically induced inflammatory response. (C) 1998 by the American Society for Dermatologic Surgery, Inc.