Prophylactic fluconazole promotes reepithelialization in full-face carbon dioxide laser skin resurfacing.

Abstract

Laser skin resurfacing is used to treat photodamaged skin, rhytids, and acne scarring. Many patients are placed on antibiotics and antivirals pre- and postoperatively. The purpose of this study was to determine whether prophylactic fluconazole increased the rate of reepithelialization in patients undergoing full-face CO(2) laser skin resurfacing. Ninety-one patients underwent full-face CO(2) laser skin resurfacing with the Coherent Ultrapulse 5000C. At least two passes of 300 mJ, density 5, were used except periocularly. Study group I consisted of 48 consecutive patients who received either cephalexin or ciprofloxacin for 7 days postoperatively. Study group II consisted of 43 patients who received 300 mg of fluconazole on postoperative days 3-8, in addition to ciprofloxacin. Both groups received acyclovir 400 mg t.i.d. pre- and postoperatively. Time to complete reepithelialization was compared between the groups by t-test. Group II reepithelialized significantly faster than group I (7.65 +/- 1.20 days vs. 10.27 +/- 2.94 days; P < 0.0001). Ninety-five percent of patients receiving fluconazole (group II) healed completely by day 9 versus only 53% of patients in group I. Fluconazole administered postoperatively between days 3 and 8 significantly promotes reepithelialization in patients undergoing full-face CO(2) laser skin resurfacing.