MONDAY, April 6 (HealthDay News) -- Severe dermatologic complications can develop in patients who undergo fractional CO₂ laser resurfacing, according to a study published online March 16 in Lasers in Surgery and Medicine.

Douglas J. Fife, M.D., of Northwestern University in Chicago, and colleagues reviewed the cases of four women aged 54 to 67 who experienced scarring or ectropion after fractional CO₂ laser resurfacing on the face or neck.

In the first patient, the researchers observed erosions and swelling of the lower eyelid, which progressed into scarring and an ectropion. In the second patient, they observed linear erosions and red swelling on the side of the neck, which turned into a tender, band-like scar. The third patient developed stinging and yellow exudate in multiple areas of the neck, the cultures from which grew methicillin-resistant Staphylococcus aureus. The fourth patient developed an asymptomatic patchy, soft eschar with yellowish change on the side of the neck, the researchers report. Despite appropriate treatment, both the third and fourth patients developed scars, the report indicates.

"It is critical to recognize, characterize, and report complications in order to recognize the limits of therapeutic efficiency, and to improve the patient safety of these devices," the authors conclude. "Infectious complications may lead to scarring in patients with fractional CO₂ laser treatment and may be prevented by prophylactic antibiotics and vigilant postoperative monitoring. Care should be taken when treating areas of thin skin such as the eyelids, upper neck and especially the lower neck, probably by decreasing the energy, the density, or both."

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