Alabaster skin after carbon dioxide laser resurfacing with histologic correlation

Dermatol Surg. 1998 Jun;24(6):633-6. doi: 10.1111/j.1524-4725.1998.tb04220.x.

Abstract

Background: Carbon dioxide laser resurfacing has gained popularity as a relatively safe and effective method of facial rejuvenation. Original reports describe mostly reversible side effects and a low incidence of scarring. Only very recently have reports of delayed hypopigmentation surfaced. This effect is not visible until several months after resurfacing, and most likely represents a permanent change.

Objective: To provide an additional clinical description of the complication of delayed hypopigmentation along with the first published histologic correlation.

Methods: Clinical records along with a preprocedure and 7-month postprocedure full-thickness skin biopsy were used for this report.

Results: This patient experienced a striking leukoderma 6 months after a full facial carbon dioxide laser resurfacing procedure done for widespread actinic keratoses. There was a zone of dermal fibrosis extending approximately 0.4 mm on the postprocedure biopsy. Comparison of the preprocedure and postprocedure biopsies revealed no difference in the number of melanocytes by MART-1 immunohistochemical staining, but there was a significant decrease in epidermal melanin as determined by Fontana-Mason staining.

Conclusion: This patient experienced a profound expression of an increasingly recognized and reported complication of carbon dioxide laser resurfacing. Histologic correlation is similar to the results previously reported after phenol chemical peels, demonstrating a normal number of melanocytes but a decrease in epidermal melanin.

Publication types

  • Case Reports

MeSH terms

  • Carbon Dioxide
  • Female
  • Humans
  • Hypopigmentation / etiology*
  • Hypopigmentation / pathology*
  • Keratosis / surgery*
  • Laser Therapy / adverse effects*
  • Laser Therapy / methods
  • Middle Aged

Substances

  • Carbon Dioxide