Short- and Long-term Side Effects of Non-ablative Fractional Laser Resurfacing in Koreans: Analysis of 286 Consecutive Treatments

Abstract

Background and Objectives The objective of this study is to determine the safety of a non-ablative fractional laser resurfacing of the face. Materials and Methods This is a retrospective analysis of Korean patients treated with a non-ablative 1,550 nm fractional laser system for facial skin problems. Prevalence, types, and nature of side effects were identified and assessed. The safety data were analyzed according to the variables, including patient demographics, laser parameters, and adjuvant medication. Results A total of 286 consecutive treatment sessions in 119 patients (mean age 32.4) were included in the analysis; 159 treatments were applied for acne scars, 81 for prominent pores/wrinkles, and 46 for other facial scars. Erythema, edema, and dryness were significantly more evident and persisted longer in patients treated with higher densities. A total of 71 (24.8%) side effects were recorded. The most frequent complication was acne flaring. Other side effects included postinflammatory hyperpigmentation, herpes viral reactivation, aggravation of rosacea and melasma, and atrophic scarring. Two patients developed melasma after treatment. Side effects occurred more frequently in males than in females. Acne-prone patients were more likely to experience flaring of perioral acne, most commonly observed in the high energy treatment group. Postinflammatory hyperpigmentation and melasma were not observed in patients treated with lower densities. Conclusion Non-ablative resurfacing with a 1,550 nm fractional laser was associated with a relatively low rate of adverse effects. However, acne flaring was more common than previously reported. Both the energy and the density was the determinant of side effects. Increased density was more likely to produce pigmentary alterations in Korean patients.