Side effects and complications of variable-pulsed erbium:yttrium-aluminum-garnet laser skin resurfacing: extended experience with 50 patients.

Recent advances in technology have provided laser surgeons with new options for cutaneous laser resurfacing. Despite its popularity, there is limited information on the short-term and long-term side effects and complications of variable-pulsed erbium:yttrium-aluminum-garnet (erbium:YAG) laser skin resurfacing. The purpose of this study was to prospectively evaluate postoperative wound healing, side effects, and complications of multiple-pass, variable-pulsed erbium:YAG laser skin resurfacing for facial photodamage, rhytides, and atrophic scarring. Fifty consecutive patients with facial photodamage, rhytides, or atrophic scarring were treated with a variable-pulsed erbium:YAG laser. Side effects and complications relating to postoperative healing, erythema, and pigmentary changes were tabulated. Patients were evaluated at postoperative days 3 through 7 and at 1, 3, 6, and 12 months after laser skin resurfacing. The average time for reepithelialization was 5.1 days. Prolonged erythema (>1 month) was observed in three patients (6 percent). Transient hyperpigmentation occurred in 20 patients (40 percent), with an average duration of 10.4 weeks. No cases of hypopigmentation or scarring were seen. In summary, a variable-pulsed erbium:YAG laser can safely be used for the treatment of facial photodamage, rhytides, and atrophic scarring. Although more postoperative erythema is seen after variable-pulsed erbium:YAG laser treatment than is usually produced with a short-pulsed erbium:YAG system, the side-effect profile and recovery period after variable-pulsed erbium:YAG laser skin resurfacing still are more favorable than after multiple-pass carbon dioxide laser skin resurfacing.