Why does carbon dioxide resurfacing work? A Review

Despite the unquestionable efficacy of carbon dioxide laser skin resurfacin g, mechanisms for cosmetic enhancement remain poorly characterized. Histolo gical studies have provided some insight into the cascade of events from in itial laser impact to final skin rejuvenation. However, there are few compr ehensive studies of gross and microscopic wound healing. Additionally, the literature is fragmented; excellent individual articles appear in journals from widely disparate disciplines. For example, some reports relevant to la ser skin resurfacing are "sequestered" in the engineering literature. This article is intended to update the physician on laser skin resurfacing based on the broadest review of the current literature. It proceeds from a discu ssion of initial laser-tissue interactions, such as collagen denaturation, to examination of longterm biological sequlae. At some cost tp scientific r igor, mathematical models describing laser-tissue interactions are not pres ented.