Complications of fractional ablative carbon dioxide laser in various aesthetic procedures: a retrospective study

Jasleen Kaur, Saurabh Sharma, Tanreet Kaur, Roopam Bassi


Background: Though fractionated CO2 laser technology resurface patients with a lower rate of complications than non-fractionated ablative laser treatment, adverse effects can still occur even with the best technology.

Methods: In this retrospective study we evaluated 65 patients for early and delayed complications after laser treatment with Sellas Cis-Fl™ fractional CO2 laser system of wavelength 106400 nm for various aesthetic indications over the period of 12 months from October 2017 to September 2018. Follow up was done for the period of 2 months after the last session to determine the nature and frequency of various complications. Patient’s subjective assessment of the complications was recorded in the form of patient subjective score (PSS) which ranged from 1 to 10.

Results: In the current study, the most common aesthetic indication for fractional CO2 laser was post acne scarring (38.4%). The most common early side effects reported were erythema (95.38%) and burning sensation (92.30%) after the procedure. Post procedural dryness and edema was seen in 72.3% and 69.23% patients. Among the delayed complications most frequently observed was persistent erythema (46.15%) followed by post inflammatory hyperpigmentation (44.61%).

Conclusions: Though fractional CO2 laser is relatively a safe procedure, undesirable sequelae may still occur as a result of inappropriate selection of laser parameter, injudicious patient selection, inadequate preoperative counselling and suboptimal postoperative care. Dermatologist should keep the possibility of all the side effects that can occur after fractional CO2 laser and must take appropriate precautions during the procedure to avoid them.


Microthermal zones, Fractional lasers, Ablative lasers

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