Long-term histologic effects of the CO2 laser.

The long-term histologic effects of CO2 laser resurfacing previously were unknown. Prior investigations have clearly defined the photothermal effect. Collagen shrinkage as a reaction to increased tissue temperature between 60 and 70 degrees C has also been previously described. Twenty-two patients completed a 1-year study in which biopsy specimens from the upper lip were taken preoperatively and 6 weeks, 6 months, and 1 year after CO2 laser resurfacing. Trichrome stains and Verhoeff-van Gieson stains were used to demonstrate tissue collagen and tissue elastin. Neocollagenesis beginning at 6 weeks and progressively increasing at 6 months and 1 year was clearly demonstrated. Neoelastogenesis showed significant increases at 6 months and 1 year. It is hypothesized that the additive effects of initial collagen shrinkage and the long-term effect of neocollagenesis and neoelastogenesis are the significant factors contributing to the long-lasting and excellent results of CO2 laser skin resurfacing.