[CO₂ fractional resurfacing: side effects and immediate complications]

Fractional resurfacing is a new concept in laser treatment designed to divide radiation into multiple evenly spaced microspots. The aim of our study was to analyze side effects and complications following fractional CO₂ laser therapy.

This retrospective study involved the analysis of records of patients treated with ablative fractional CO₂ laser. Pain, type and duration of usual side effects, and immediate complications were analysed.

Forty-six treatments were studied. The average duration of erythema was 5.2 (±2) days while that of scabs was 4.1 (±1.9) days. Average pain was 3.3/10 (±2.5) for nine patients premedicated with Emla® and 4.1/10 (±2) for the other 14 non-premedicated patients. Complications were reported for 21.7% of the 46 treatments, as follows: 10.6% facial herpes, some of which occurred despite antiviral prophylaxis (valacyclovir 500 mg/day p.o.), 8.7% inflammatory reactions, including severe facial swelling, and 2.2% acne. All complications resolved quickly.

Our study specifically examined the safety of CO₂ fractional lasers and showed an acceptable per interventional pain and simple follow-ups. The frequency of complications was high compared to that described with the Fraxel®, but no severe complications were reported. Given the extent of herpes complications, our study encourages the prescription of valacyclovir prophylaxis 500 mg twice a day for all patients. Patients should also be informed of the high risk of severe inflammatory reaction.