Treatment of CO2 Laser Induced Hypopigmentation With Ablative Fractionated Laser Resurfacing: Case Report and Review of the Literature

Background: The carbon dioxide laser (CO2) has been proven to be an effective device for the treatment of photoaging. However, it is associated with adverse side effects including prolonged erythema, edema, burning, milia, acne, crusting and hypo-/hyperpigmentation. Delayed onset hypopigmentation after CO2 laser resurfacing can markedly detract from clinical outcomes. To overcome the disadvantages of traditional ablative and non-ablative resurfacing, fractional photothermolysis (FP) has been introduced. FP has been demonstrated in early case reports and case series to produce significant improvement in hypopigmentation of acne and surgical scars. Case Report: A 53-year-old Caucasian female with Fitzpatrick type I skin presented with a nine-month history of delayed onset hypopigmentation following ablative CO2 laser resurfacing. After a series of three treatments at eight-week intervals with an ablative fractionated CO2 laser device, the hypopigmentation and line of pigmentary demarcation between the face and neck improved by 75 percent. Conclusion: Ablative fractional resurfacing is a safe and potentially effective modality for the treatment of CO2 laser induced hypopigmentation on the face.