Complications of carbon dioxide laser resurfacing and their prevention

Carbon dioxide laser resurfacing has gained widespread acceptance. Although advances in laser technology have greatly improved this technique and minimized operator error, adverse outcomes and complications still occur. Many of these complications can be readily avoided. In our series of 1925 patients, undesirable outcomes occurred mainly in the early stages of our experience and could be attributed to poor preoperative evaluation, faulty technique, and suboptimal postoperative care. Five hundred thirty-seven (28%) patients perceived an adverse outcome. Four hundred sixty-one (24%) of the 1925 patients had either normal sequelae or complications that were readily preventable with proper preoperative evaluation and improved postoperative care. Only a small percentage (10/1925 [0.5%]) were the result of poor technique. It appears that our energies need to be directed toward perioperative factors. After 5 years' experience, our incidence of adverse reactions has been reduced to 2.7% as a result of our better understanding of skin healing and prevention of possible complications.