The use of the carbon dioxide laser for skin resurfacing was initially described in 1989. 1 Since that time, several reports have shown it to be highly effective in the treatment of photodamaged skin and acne scarring. 2,3,4,5 Advances in laser technology have simplified the procedure and minimized adverse sequelae. Laser skin resurfacing has become a very popular technique, and recently several patient series have been published on the use of different resurfacing lasers to treat photodamaged skin. 3,4 However, very little has been written about its complications. Adequate patient selection, sound medical judgement, proper training with experience and knowledge of skin physiology and wound care are important factors for successful outcomes. Interested physicians across a broad range of subspecialties have expressed concern about the rate of adverse outcomes and management of complications. We report seven representative cases of complications referred to our dermatology clinics from outside physicians, in the hope of educating clinicians regarding the usual and unusual side effects of this procedure.

To our knowledge this is the first case of solar-induced PIHP following laser hair removal. The treatment of PIHP is difficult because there are few therapeutic options that are consistently successful. Avoidance of exposure to ultraviolet light should be emphasized to all patients prior to laser therapy. We demonstrated that serial TCA peels provided an additional benefit compared to medical treatment.

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A premature boy was transferred to a neonatal intensive care unit shortly after birth because of respiratory distress, jaundice, hepatosplenomegaly, thrombocytopenia, and an elevated IgM level. His course was complicated by pneumonia, congestive heart failure secondary to cor pulmonale, and repeated apneic episodes. His EEGs at 3 and 5 months of age were normal.Shortly after the second EEG, skin lesions were noted in the distribution of the previously applied EEG leads on his scalp and earlobes (Fig 1). Each lesion was a discrete, approximately 1-cm red papule surmounted by multiple yellowish milia. A biopsy specimen of one lesion showed a well-circumscribed, focal collection of calcium in the upper reticular dermis surrounded by a moderate infiltrate of histiocytes and lymphocytes (Fig 2).Six similar cases are summarized in the Table. Lesions disappeared in two to six months without therapy. During this time the lesions were tender, and tiny, hard bits of material were extruded. This period is slightly longer than previously noted in an adult.' In our experience, spontaneous resolution produces a result cosmetically superior to surgical removal.Abrasion of skin before application of electrode paste is a standard practice for EEG technicians.^At our hospital the technique is as follows:1. The areas selected for electrode placement are wiped with acetone.