Ultrapulse Carbon Dioxide Laser Research Articles

Evaluating the Long-Term Outcome of the Ablative Lasers in the Treatment of Facial Angiofibromas in Tuberous Sclerosis: A TwoYear Follow-Up Study

Background: Tuberous sclerosis (TS), a genetic multisystem disorder, is characterized by widespread hamartomas in multiple organs. The classic clinical symptoms consist of angiofibromas, epilepsy, and developmental delay. Dermatological change is one of the major features. Bilateral facial angiofibromas (FA), a common form of presentation, cause significant cosmetic, medical, and emotional problems. The emerging treatment for skin lesions is laser therapy. However, there is no report on the long-term outcome of combined use of ultra-pulse carbon dioxide (UPCD) laser and ablative fractional (AF) Er: YAG lasers to treat skin lesions in patients suffering TS. Methods: A retrospective study, conducted from March 2014 to July 2018, investigated 9 patients from the Northwest part of China who had TS treated with a sequential treatment of UPCD laser and AF Er: YAG laser. Results: The sequential use of the UPCD and AF Er: YAG laser is a safe and effective method for the treatment of FA in patients suffering TS with satisfactory long-term outcomes. Conclusions: The sequential use of the UPCD and AF Er: YAG laser is a safe and effective method for the treatment of FA in patients suffering TS with satisfactory long-term outcomes.

A Prospective Interventional Study of Xanthelasma Palpebrarum Treated with Ultrapulse Carbon Dioxide Laser

Introduction: Xanthelasma palpebrarum (XP) is the most common of all the xanthomas which presents as asymptomatic, often bilateral, soft, yellow, papules and plaques around the eyelids. Although, the lesions are benign, it is aesthetically upsetting. The surgical laser is the most effective treatment modality to this problem. Aim: To evaluate the efficacy and safety of ultrapulse Carbon dioxide (CO2) laser in XP in Indian patients. Materials and Methods: It is a prospective, interventional study carried out for two years in which 29 patients with 61 XP lesions were part of the study. Ultrapulse CO2 (Fraxis Duo laser; 10,600 nm) laser treatment was done in every patient for a single sitting. Statistical significance was calculated using Chi-square test using Statistical Packages for Social Sciences (SPSS) version 19.0. The p-value of 0.001 was considered statistically significant. Results: A total number of 29 patients with 61 xanthelasma lesions were included in the study, of which 11 were males and 18 were females with an age range of 27-54 years. In the present study XP lesions were completely resolved in majority (54 lesions in 25 patients) of treated patients. No intraoperative complications were observed. Two patients showed hypopigmentation. There was neither scarring nor recurrence seen after six months follow-up. Conclusion: Ultrapulse CO2 laser is a safe and effective option of treatment for xanthelasma. It is considered as less painful procedure with fewer side effects and recurrences in the present study.

Efficacy of ultrapulse carbon dioxide laser ablation versus 30% trichloroacetic acid in xanthelasma palpebrarum - A randomised controlled trial

Context: Xanthelasma palpebrarum (XP) is the most common cutaneous xanthoma that develops around the eyes. A number of treatment modalities have been tried for its removal, but none are truly satisfactory. Trichloroacetic acid (TCA) is commonly used in Indian setting as it is easily available and cost-effective whereas carbon dioxide (CO2) laser has been tried increasingly due to its favorable cosmetic outcome. Aims: This study aims to compare the efficacy of ultrapulse CO2 laser ablation with 30% TCA in the treatment of XP. Setting and Design: Prospective, interventional, randomized study at a Dermatology Centre of a Tertiary Level Hospital from January 2017 to June 2018. Methods: Seventy-four patients with 100 lesions of XP were divided into two groups of flat and elevated lesions. Each group was further randomly divided into two subgroups and administered CO2 laser once a month and 30% TCA once in 2 weeks respectively for 3 months. Patients were clinically assessed at baseline and then at monthly intervals using visual analog scale (VAS), patient satisfaction score (PSS), and standardized photographs. The follow-up was done at the end of 3 and 6 months. Statistical Analysis and Results: Mean PSS and VAS score of TCA and laser in flat and elevated lesions were compared using independent group Student's t-test. Response to laser in elevated lesions was found to be statistically better whereas in flat lesions the response to TCA and laser were similar. Recurrence was 17% and 6% at 3 months' follow-up and 24% and 11% at 6 months' follow-up in TCA and laser groups, respectively. Conclusions: The end results of ultrapulse CO2 laser and 30% TCA are comparable in flat lesions of XP. In elevated lesions, laser has better efficacy, requires fewer sittings with lesser chance of recurrence.

Ultra-pulsed Carbon Dioxide Laser for the Treatment of Melanocytic Nevi

Abstract: Congenital melanocytic nevi (CMN) even small-sized as well as acquired melanocytic nevi (AMN) are of common cosmetic concerns and getting rid of them remain challenging. The aim of this study is to evaluate the efficacy and safety of the ultra-pulsed CO2 laser for the treatment of melanocytic nevi. 15 male and female Libyan patients with 16 AMN and 7 CMN were treated with multiple sessions of ultra-pulsed CO2 laser at 1-month intervals. Clinical response at 6 months after final treatment was graded as poor (< 50%), moderate (50–75%), good (> 75%) and excellent where the skin of the lesion returned normal as the rest of the surrounding skin. All treated nevi showed good to excellent cosmetic outcomes after 2 or 4 treatment sessions. The post laser complication were minimal and transit except for one atrophic scar. No recurrence of pigmentation during the six months of follow-up period. Conclusion: Ultra-pulsed CO2 laser seems to be effective and associate with minimum adverse side effect in the treatment of small CMN and AMN.

Multiple Apocrine Hidrocystomas of the Eyelids: A Case Successfully Treated Using Ultrapulsed Carbon Dioxide Laser and Literature Review

Apocrine hidrocystomas of the eyelids are cystic tumors that have their origin in the glandular portion of the apocrine gland; in most cases they cause only mild or absent symptoms, but they may annoy patients when in huge number, usually interfering with the field of view and disfiguring of upper part of the face. Consequently, those affected usually ask these lesions to be removed. Although a solitary lesion can be treated easily with surgical excision, the elimination of multiple lesions may be problematic because of their number and locations. Many approaches were proposed for solving this particular clinical presentation. We present a difficult case of multiple apocrine hidrocystomas successfully treated using carbon dioxide laser with a good cosmetic outcome taking the opportunity for a literature review.

Comparative Evaluation of Clinical Outcomes of Laser Skin Resurfacing Using an Ultra-Pulse Carbon Dioxide Laser and Manual Dermabrasion Using a Medium-Grit Drywall Sand Screen for Scar Revision in Adults: A Split-Scar Prospective Study

The purpose was to evaluate the clinical outcomes of laser skin resurfacing using an ultra-pulse carbon dioxide (CO2) laser and manual dermabrasion with a medium-grit drywall sand screen for scar revision in adults with Fitzpatrick skin type III to V. A total of 20 postsurgical and post-traumatic scars in individuals with Fitzpatrick skin type III to V were included in this study. Preoperative evaluation of the scars was performed by 3 blinded observers using the Manchester scar rating scale. Each scar to be treated was divided into 2 equal halves, and each half was randomly allotted to either ultra-pulse CO2 laser resurfacing (group A) or manual dermabrasion (group B). Postoperative clinical evaluation was performed by the same observers using the Manchester scar rating scale at the end of the first month, third month, and sixth month. This study showed that both methods were effective in improving the appearance of the postsurgical and post-traumatic scars. No significant difference was found between them (P=.978). Hyperpigmentation occurred in 4 scars in both the half treated with manual dermabrasion and the half treated with laser resurfacing; however, it had resolved by the end of the sixth month in all 4 scars. CO2 laser resurfacing and manual dermabrasion are equally efficacious and safe methods for scar resurfacing in adults with Fitzpatrick skin type III to V.

Clinical efficacy of fractionated ultrapulse carbon dioxide laser combined with microneedle for the treatment of acne scars

Objective To investigate the clinical efficacy of fractionated ultrapulse carbon dioxide laser combined with microneedle for depressed acne scars. Methods Totally 86 patients with depressed acne scar were randomly divided into 2 groups: the treatment group received fractionated ultrapulse carbon dioxide laser combined with microneedle technology and the control group only received fractionated ultrapulse carbon dioxide laser. The treatment interval was 1 to 3 months, and the whole course was 2-8 times. The total effective rate and the adverse reaction were analyzed in the facial acne scar. Results The surface of depressed acne scars was significantly improved. ECCA score of all patients declined obviously after treatment, the score of the treatment group declined from 61±11 to 45±15, and the control group declined from 57±14 to 40±16. There were significantly statistical differences in the results of each group (P<0.05). More treatment times resulted in better surface improvement. The total effective rate were 81.8% (18/22) and 100% (24/24) in the treatment group, and 80.0% (16/20) and 100% (20/22) in the control group. The course was 6.8±1.6 months in the treatment group and 20.8±4.6 months in the control group (P<0.05) to get a similar satisfied result. There were no obvious adverse reactions except two cases of erythema and pigmentation in the treatment group and 5 cases in the control group. The former was with less adverse reactions. Conclusions Ultrapulse carbon dioxide laser combined with microneedle technique is effective for facial acne scars, with less complications and shorten treatment course. Key words: Fractional laser; Micro needle; Acne scars

Clnical observation, of the effects of lattice ultra pulse carbon dioxide laser combined with traditional Chinese medicine on the treatment of hyperplastic scar

To explore the clinical effects of lattice ultra pulse carbon dioxide laser combined with traditional Chinese medicine ( Fuchunsan ) on the treatment of postburn hyperplastic scar. Sixty-three patients with hyperplastic scar after burn injury hospitalized from February 2012 to June 2014 in our department were treated with lattice ultra pulse carbon dioxide laser combined with traditional Chinese medicine (Fuchunsan). Patients were divided into early stage group (E, n = 35), middle stage group (M, n = 25), and late stage group ( L, n = 3) according to the formation time of scar, which was respectively 3 weeks to 3 months, longer than 3 months and less than or equal to 6 months, and 3 to 15 years in groups E, M, and L. The number of times of laser treatment of patients in each group was recorded. The degree of scar pain in patients of the three groups was assessed by the Numerical Rating Scale (NRS) before treatment and after treatment for 1, 2, and 3 times. The scar condition of patients in groups E and M was assessed by the Vancouver Scar Scale (VSS) before treatment and after treatment for 1, 3, and 5 times. Patients in group L did not receive VSS assessment but were evaluated by clinical observation only. Photos of scar in treating area were taken before treatment and after treatment for 3 and 5 times to evaluate the clinical effect. Data were processed with t test. Patients in groups E and M were treated with laser for (4.8 ± 1.1) and (7.7 ± 2.1) times respectively. In group L, the treatment was stopped in 2 patients after laser treatment for 5 times, and 1 patient received laser treatment for 12 times. The degree of pain in patients of groups E and M was alleviated significantly after treatment for one time, and the number of patients scoring 1-4 point(s) in NRS increased from 5 cases to 38 cases. After treatment for 2 and 3 times, the increase in the number of patients scoring 1-4 point (s) in NRS was on a small scale. Before treatment and after treatment for 1 time, VSS scores of patients in groups E and M were similar (with values respectively 0.641 and 0. 082, P values above 0. 05). After treatment for 3 and 5 times, VSS scores of patients in group E were respectively (9.2 ± 0.8) and (7.0 ± 1.1) points, which were significantly lower than those in group M [ (9.7 ± 1.0) and (8.2 ± 1.0) points, with values respectively -1.993 and -4.433 , P < 0.05 or P < 0.01]. After treatment for 3 times, the rate of improvement in appearance was respectively 88.6% (31/35) and 72.0% (18/25) in groups E and M, and it was respectively 100.0% (35/35) and 96.0% (24/25) after treatment for 5 times. No significant effect in appearance was found in the 3 patients in group L. Early application of lattice ultra pulse carbon dioxide laser combined with traditional Chinese medicine (Fuchunsan) for the treatment of postburn hyperplastic scar is effective.

Efficacy of ultrapulse carbon dioxide laser for the treatment of facial angiofibroma in patients with tuberous sclerosis: an observatioal study

Objective To estimate the clinical efficacy and adverse effects of ultrapulse carbon dioxide laser for the treatment of facial angiofibroma in tuberous sclerosis patients, and to observe the recurrence of facial angiofibroma in the patients after treatment with ultrapulse carbon dioxide laser. Methods Thirty-six tuberous sclerosis patients with facial angiofibroma were enrolled in this study. Ultrapulse carbon dioxide laser(Ultrapulse Encore)was used for the treatment of facial angiofibroma in these patients. Laser parameters were selected according to the type of skin lesions. Results Finally, 28 patients who received single irradiation treatment and completed 6-month follow up were evaluated for efficacy and safety. Of the 28 patients, 10 were cured, 10 showed marked response, 5 response, 3 no response, and 18 experienced recurrence, with the response rate, marked response rate and recurrence rate being 89.3%, 71.4% and 64.3% respectively. Patients with a relatively small number of sparsely distributed primary lesions showed a relatively good response. There was no significant correlation between the response rate and patients′ age, gender or medical history(all P> 0.05). No permanent pigmentation, depigmentation, atrophy or hyperplastic scar was observed in any of these 36 patients. Conclusions Ultrapulse carbon dioxide laser is effective for the treatment of facial angiofibroma in tuberous sclerosis patients with few adverse effects but high recurrence risk. There seems to be a relatively good response to ultrapulse carbon dioxide laser in patients with a small number of primary lesions. Key words: Lasers, gas; Tuberous sclerosis; Face; Angiofibroma; Treatment outcome

Ultrapulse carbon dioxide laser ablation of xanthelasma palpebrarum: A case series

Context:Xanthelasma palpebrarum is the most common form of xanthomas. Albeit a benign entity, it is cosmetically disturbing and a frequently recurring dermatologic referral. Although the classical treatment option remains surgical excision, alternatively, chemical cauterization, cryosurgery and electrofulguration have all been tried in the past with mixed results. The use of laser systems such as carbon dioxide laser, Erb:YAG laser, Q-switched Nd:YAG laser, diode laser, pulsed dye laser and KTP laser have become popular in the treatment of these lesions. Recent literature suggests minimal pigmentary changes and scarring with the use of ultrapulse carbon dioxide laser treatment of these lesions.Aim:To study and evaluate the effectiveness of ultrapulse carbon dioxide laser ablation for treatment of xanthelasma palpebrarum.Materials and Methods:10 patients presenting with bilateral xanthelasma palpebrarum, new and with recurrence were studied for results after a single treatment with ultrapulse carbon dioxide laser (10,600 nm; 100-200 Hz; 200-400 μsec). The follow-up time was 9 months.Results:All lesions were treatable with a single-laser treatment session. Two patients (20%) developed recurrence during the follow-up period. Side effects included post inflammatory hyperpigmentation in two patients (20%), but no visible scarring was observed.Conclusions:The ultrapulse carbon dioxide laser is an effective and safe therapeutic alternative in treatment of xanthelasma palpebrarum.

Dystrophic Calcification and Accentuated Localized Argyria After Fractionated Carbon Dioxide Laser Therapy of Hypertrophic Scars

Fractionated, ultrapulsed carbon dioxide (CO2) laser therapy is a powerful tool for the treatment of scars. Common adverse effects of this therapeutic modality have been previously documented. We describe 2 unreported adverse effects of ultrapulsed CO2 laser treatment of mature scars in a patient previously treated with silver-impregnated dressings. A teenage survivor of toxic epidermal necrolysis presented with faint but diffuse dyschromia clinically and histologically consistent with localized argyria secondary to silver-impregnated dressings used years earlier. The patient was subsequently treated with fractionated CO2 for her scarring, but her hyperpigmentation worsened with each treatment. A subsequent biopsy specimen revealed a zone of dystrophic calcification with adjacent pseudo-ochronotic fibers that were not appreciated on biopsy specimens taken before CO2 laser treatment, suggesting unique complications not previously reported. We present 2 unique complications secondary to ultrapulsed, fractionated CO2 laser treatment in a patient previously treated with silver-impregnated dressings: (1) the appearance of pseudo-ochronotic fibers in areas of worsening pigmentation and (2) evidence of dystrophic calcification limited to columns of fractionated laser ablation. Therefore, a history of argyria or treatment with silver-impregnated dressings should be considered before treatment with fractionated CO2 lasers.

63 Intravascular laser blood irradiation of different spectral and frequency range in the correction of hormonal imbalance of patients with bronchial asthma

For patients seeking aesthetic rejuvenation of the eyes, transconjunctival blepharoplasty is an effective means of dealing with proptotic lower eyelid fat. For dermatochalasis of infraorbital skin, Ultrapulse carbon dioxide (CO2) laser resurfacing can be used simultaneously with blepharoplasty to “tighten” periorbital skin. This article describes the technique, results, and complications in a series of 101 patients. Histological and electron microscopic study of laser wounding provides an understanding of tissue biophysics unique to human eyelid skin. The entire procedure can be performed with the laser, by starting with a 0.2 mm CO2 laser handpiece to incise the conjunctiva and resect fat, then switching to a computer pattern generator (CPG) for skin resurfacing. Meticulous hemostasis, avoidance of the inferior oblique muscle, and complete fat excision are the mainstays of this procedure. The technique has been extremely safe and free from complications of ocular morbidity, bleeding, ectropion, scleral show, hypopigmentation, skin slough, or scarring. There was one case of herpes simplex. Duration of healing averaged 7 weeks when the CPG was used. In contrast, the single-spot, manual sweep handpiece significantly prolonged erythema to 11 weeks or more. The incidence of hyperpigmentation was 16%, and equal in patients undergoing transconjunctival blepharoplasty with resurfacing and those receiving periorbital laser resurfacing alone. Treatment with hydroquinone cleared all patients. Histological study showed variance in total eyelid skin thickness, from 483 to 1,371 μms with epidermis comprising 63.5 μm on average. The first pass of the laser characteristically exfoliates the epidermis in a clean plane, 60 to 80 μm, with nominal dermal effect. A second pass produces dermal coagulation of approximately 40 μms, sparing adnexal structures. With a second pass of the laser, electron microscopy confirms collagen fibril contraction in the reticular dermis, with a 30% increase in diameter and a 9% contraction in periodicity. At the same level, microvasculature is preserved. Transconjunctival lower lid blepharoplasty, performed with Ultrapulse CO2 laser incision and skin resurfacing, avoids morbidity typically associated with standard subciliary blepharoplasty, and with no increase in ocular or laser-related sequelae. For resurfacing, two passes with the CPG enhances dermal collagen contraction, and dermal viability and collagen contraction are confirmed by microscopic examination.

Ultrapulse Carbon Dioxide Laser Treatment of Porokeratotic Eccrine Ostial and Dermal Duct Nevus

Porokeratotic eccrine ostial and dermal duct nevus (PEODDN) is a rare, benign, cutaneous hamartoma. Approximately 45 cases of PEODDN have been reported, with little information regarding treatment. We report a patient with PEODDN treated successfully using an ultrapulse carbon dioxide laser.

Transplantation of autologous minigrafts for the treatment of stable vitiligo

Background: Surgical treatment of vitiligo is indicated when lesions are localized in poorly responding areas. Various surgical procedures are used to treat stable vitiligo with an inherited shortage in each one. Objectives: To evaluate the usefulness of the treatment of transplantation of autologous minigrafts for (local and generalized) stable vitiligo. Methods: Eight patients (three males and five females) with stable vitiligo qualified for the study. They were treated with autologous minigrafts after ultrapulsed carbon dioxide laser abrasion. Results: Seven patients showed excellent to good repigmentation with an average of 84.4% coverage of the treated patches. One patient had a poor response after at least 6 months of follow-up. Conclusions: Autologous minigrafts with ultrapulsed carbon dioxide laser abrasion appear to have the potential to achieve complete repigmentation in patients with stable vitiligo who fail to respond to medical treatments.

Current State of Scanning Micromanipulator Applications with the Carbon Dioxide Laser

The development of the scanning system AcuBlade has considerably enhanced carbon dioxide laser energy delivery, improving cutting and ablation modes. The scanning system can be applied with the 2 available high-powered pulsed waves, SuperPulse and UltraPulse. This study was conducted to determine whether there are any differences in phonosurgery between the SuperPulse and UltraPulse lasing applications with regard to thermal diffusion into the surrounding tissues, healing time, and clinical results. Thirteen patients with bilateral and similar vocal fold lesions underwent operation--one side in SuperPulse mode and the other side in UltraPulse mode. The parameters for phonosurgery were depth of 0.2 mm, 10 W, single pulse, and 0.10 second for SuperPulse, and 2 passes, 10 W, single pulse, and 0.10 second for UltraPulse. Incisions were sharper with UltraPulse, making the surgery easier, but at the first postoperative follow-up visit, after 8 to 10 days, no differences were observed in the presentation, the healing, or the vibration of the 2 vocal folds. Coagulation along the incision line was 25 microm for SuperPulse and 15 microm for UltraPulse (median values). In comparison with SuperPulse, the UltraPulse carbon dioxide laser made the procedure easier, but did not improve the clinical outcome.

Facial resurfacing: An overview

Facial resurfacing is a broad topic referring to procedures that change the texture and appearance of skin. Resurfacing procedures are broadly classified as ablative or nonablative. Ablative procedures are considered the first line treatment for the most common indications for facial resurfacing, which are photoaging and acne scarring. The goal of this review is to provide an overview of the factors that optimize the clinical efficacy of an ablative procedure, including careful patient selection, preoperative skin preparation, correct operative technique, and vigilant postoperative care, as well as review both the traditional and some of the latest technologies that effectively resurface facial skin.

Treatment of Small Congenital Nevocellular Naevi Using a Combination of Ultrapulse Carbon Dioxide Laser and Q-Switched Frequency-Doubled Nd-YAG Laser

This report describes treatment combining Ultrapulse CO(2) laser and Q-switched frequency-doubled neodymium:yttrium-aluminum-garnet (Nd-YAG) laser for a number of congenital nevocellular naevi (CNN). The Ultrapulse CO(2) laser removes the superficial component, which contains most of the color, preserving the integrity of the reticular dermis. At a later stage, any residual color is targeted using the Nd-YAG laser. To date, a total of 10 histologically proven CNNs have been treated at the Laser Suite. The median age of the patients was 18 years (range, 13-24 years). All the patients were white females. The patients accepted for treatment had relatively small lesions (mean surface area, 352 mm(2); range, 50-1,092 mm(2)), but the lesions were either cosmetically sensitive or located in an anatomically critical area in which excision could result in a scar that would be unpredictable. The median follow-up period was 24 months. The overall results have been satisfactory, with reduction of color and no significant scarring. The minor textural and pigmentary changes were acceptable to the patients.

Long-Term Results of Ultrapulsed Carbon Dioxide Laser Resurfacing of the Mediterranean Face

In Mediterranean countries, increased exposure to sunlight accelerates aging of the skin and the formation of wrinkles. The long-term follow-up results for the patients who underwent resurfacing with ultrapulsed carbon dioxide (CO(2)) laser are presented. All 47 patients who underwent ultrapulsed CO(2) laser between 1994 and 1996 were included in the study. The patients were photographed with their permission before the laser treatment, at postoperative month 6, and at year 5, with comparison of the results. In this study, with its 5-year follow-up period, it was found that the ultrapulsed CO(2) laser achieved long-lasting and acceptable facial resurfacing. The ultrapulsed CO(2) laser enables damage to the abnormal dermal region with high-energy transfer in a very short period. The recent development of high-energy pulsed CO(2) laser has generated much renewed enthusiasm for cutaneous resurfacing, especially over the long term.

Combined early treatment of congenital melanocytic naevus with carbon dioxide and NdYag lasers

Three cases of extensive congenital melanocytic naevi were treated with a combined approach using a ultrapulse carbon dioxide laser and a Nd Yag laser within 1 year of birth. The naevi were substantially depigmented and this result has been maintained for up to 36 months following treatment. The condition, treatment and the relevant literature are discussed.

Optimizing wound healing in the face after laser abrasion

Background: Laser resurfacing is a popular procedure to improve the physical signs of photoaging. In addition to improvements in treatment modalities, optimizing posttreatment regimens will enhance patient care. Objective: Our purpose was to evaluate the efficacy of two forms of wound care for the face after laser abrasion. Methods: Forty-two patients received full-face laser resurfacing at two clinics by using either the UltraPulse carbon dioxide (CO2) laser (Coherent Laser Corp, Palo Alto, Calif) alone or followed by an erbium:YAG laser (Derma-20, ESC Sharplan, Inc, Needham, Mass) and/or a blended CO2/Er:YAG laser (Derma-K, ESC Sharplan) or a variable pulse erbium:YAG laser (Contour, Sciton Laser Corp, Palo Alto). Twenty-one patients were randomly assigned to a postoperative regimen including Silon-TSR (Bio Med Sciences, Inc, Allentown, Pa) for the first 2 to 3 days after laser resurfacing, followed by Aquaphor ointment (Beiersdorf, Charlotte, NC) to complete the first 2 weeks. The other 21 patients received the resurfacing recovery system (RRS, Neutrogena, Los Angeles, Calif) following a specific regimen. The system includes Fibracol wound dressing (Johnson & Johnson, Skillman, NJ) for 2 days, followed by a hydrogel dressing for 1 to 2 days, followed by an ointment to complete the first 2 weeks. Patients were evaluated for wound healing on days 2, 3, 6-10, 14-16, and 28-30. The skin was swabbed for colonization at every visit to determine the quantity of bacteria throughout the healing process. Results: Ninety percent of patients in both groups experienced either “no pain” or “minimal pain” during the first 3 days. Total bacterial counts peaked on days 3 and 6 in the patients managed with the RRS and the Silon-TSR/Aquaphor regimen, respectively. The average day at which patients did not require a dressing was 3.0 days in the group managed with the RRS and 3.7 days in the group managed with the Silon-TSR/Aquaphor dressing regimen (P ≤ .05). The average day of complete epithelial regeneration was significantly shorter at 6.3 days using the RRS compared with 7.4 days for patients using the Silon-TSR/Aquaphor regimen (P ≤ .02). There was no difference in infection, adverse sequelae, exudate management, or pain in either group. Conclusion: Healing was optimized in patients using the RRS after laser resurfacing. (J Am Acad Dermatol 2002;46:399-407.)