Fire and Ice

Adverse events associated with nonablative cutaneous visible and infrared laser treatment

“…If the hand piece is not held perpendicular to the treatment area, the cryogen spurt and laser pulse can be misaligned, resulting in blistering or unwanted pigmentary changes. 26 In some cases, cryogenic cooling systems themselves may cause unwanted effects: in 2004, a study of 57 patients treated for facial scarring recorded a hyperpigmentation rate of 39% (n = 22; mild in 17, moderate in 5). The patients, all treated with a 1450-nm diode laser, had Fitzpatrick skin types IV and V. The investigators suggested that the hyperpigmentation may have been a result of the sensitivity of Asian skin types to injury from the cryogenic spray cooling system.…”