Resurfacing of photodamaged skin on the neck with an UltraPulse (R) carbondioxide laser

Background and Objective: Successful treatment of facial wrinkles with carb on dioxide or erbium laser resurfacing brings about a more youthful appeara nce of the skin on the face. A variable degree of contrast with the untreat ed skin on the neck prompts many patients to request treatment for photodam aged skin on the neck. The objective is to investigate the feasibility of r esurfacing photodamaged skin on the neck with the UltraPulse(R) carbon diox ide laser. Study Design/Materials and Methods: The study was carried out in two phases . During the first phase, a small area on the upper neck was tested with th ree different parameters. The best parameter was then used to treat the nec k area in a single pass in 10 cases in the second phase. Patients were then evaluated at 3-6 months. Results: The three parameters tested were 200 mJ at CPG settings of pattern 3, size 9, density 6,300 mJ at CPG 3-9-5, and 300 mJ at CPG 3-9-6. The lat ter seemed to achieve the best results, and there were no complications at any test sites. This setting was used to treat the whole anterior and anter olateral part of the neck with a single pass, wiping away the resultant epi dermal debris. Moderate improvement in color and texture, but no improvemen t in wrinkling, were observed at 3-6 months. However, a mild degree of patc hy hypopigmented scarring in the lower neck was encountered in three cases, as well as one other case of patchy hypopigmentation without textural chan ges. Conclusion: Despite some obvious improvements, the risk of scarring and hyp opigmentation with the tested parameters out-weighs the potential benefits. The lower part of the neck responded very differently from the upper part. Alternative strategies to achieve better results are discussed.