A split-face comparison of two ablative fractional carbon dioxide lasers for the treatment of photodamaged facial skin

OBJECTIVE: To compare the safety and efficacy of two fractional carbon dioxide (CO₂) laser devices for the treatment of photodamaged facial skin. METHODS: Eight healthy subjects underwent full-face resurfacing for photodamaged skin with two fractionated CO₂ laser devices using manufacturer-recommended settings for facial rejuvenation. For each subject, one device with a rolling handpiece was used on one side and a second device with a stamping handpiece was used on the other. Patients were evaluated 3 months postoperatively and photographed. A blinded physician investigator assessed the photographs and rated each side for improvement in four categories (wrinkles, pigmentation, skin laxity, and overall appearance). Patient ratings for overall improvement for each side were also recorded. RESULTS: All patients had improved on the basis of photographic and clinical assessments at 3 months. No significant differences in patient ratings of overall improvement and physician-measured parameters of clinical improvement were found, although intraoperative times and pain ratings were greater with the laser with the stamping handpiece. No complications were experienced with either device. CONCLUSIONS: Both fractionated CO₂ resurfacing devices used in the study were safe and effective for the treatment of photodamaged facial skin, but the modality using a stamping handpiece was associated with longer operative times and greater intraoperative pain.