Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

Abstract

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.

Efficacy and adverse reactions of fractional CO2 laser for atrophic acne scars and related clinical factors: A retrospective study on 121 patients

“…Compared with traditional ablative and non‐ablative laser, fractional CO 2 laser enables a faster recovery, less adverse reactions, and a stronger efficacy 6,7,9 . However, factors accounting for its efficacy and adverse reactions remain unclear 10,11 . In this study, we reviewed the clinical data of 121 patients receiving fractional CO 2 laser for facial atrophic acnes and analyzed factors influencing the efficacy and adverse reactions of the therapy.…”

“…6,7,9 However, factors accounting for its efficacy and adverse reactions remain unclear. 10,11 In this study, we reviewed the clinical data of 121 patients receiving fractional CO 2 laser for facial atrophic acnes and analyzed factors influencing the efficacy and adverse reactions of the therapy.…”

An overview on the role of CO 2 laser in general dermatology

“…Finally, much more rarely, there may be adverse effects such as hypertrophic scarring or infections of the treated site that are often linked more to poor wound management than to treatment. [29][30][31]…”

Clinical efficacy of different therapeutic modes of CO2 fractional laser for treatment of static periocular wrinkles in Asian skin

“…Many fractional ablative laser devices have been used in treatment of periocular wrinkles with a wavelength ranging from 2790 nm to 10 600 nm 7 . However, limited clinical efficacy and risk of post‐inflammatory hyperpigmentation have always been concerns for Asian populations since their skins are more vulnerable to thermal damages.…”

“…Many fractional ablative laser devices have been used in treatment of periocular wrinkles with a wavelength ranging from 2790 nm to 10 600 nm. 7 However, limited clinical efficacy and risk of postinflammatory hyperpigmentation have always been concerns for Asian populations since their skins are more vulnerable to thermal damages. A CO 2 fractional ablative laser with multiple energy delivery modes such as CO 2 RE may provide more advantages than other conventional fractional ablative lasers for resurfacing treatment.…”