Disappointing results following resurfacing of facial skin with CO2 lasersfor prophylaxis of keratoses and cancers

BACKGROUND. With the development of the short-pulse CO2 laser it was hoped that this resurfacing would prevent recurrent actinic keratoses and basal c ell cancers similar to resurfacing with dermabrasion, laser abrasion, and d eep chemical peel. However, we have begun to see patients that are developi ng keratoses and cancers within months following laser resurfacing. OBJECTIVE. TO document the problems of recurrent keratoses and basal cell c ancers in patients following CO2 laser resurfacing. METHODS. Thirty-five patients with extreme sun damage were seen at 3, 6, an d 12 months following CO2 laser resurfacing for repeat color and ultraviole t photography and clinical examination to look for erythematous dyskeratoti c lesions or papules with pearly borders. RESULTS. Five of our patients (14 .3%) who had undergone recent CO2 resurfacing developed actinic keratoses a nd basal cell cancers. CONCLUSION. CO2 laser resurfacing is not as effective as dermabrasion, chem abrasion, and deep chemical peel for the prophylaxis of actinic keratoses a nd basal cell cancers, especially in Fitzpatrick type I and II patients.