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BACKGROUND Although unparalleled in its efficacy, carbon dioxide (CO2) laser resurfacing has a high risk:benefit ratio. A modified device uses a novel handpiece and software to deliver nonsequential fractional ablative CO2 laser exposures.

OBJECTIVE To evaluate the safety and efficacy of this fractional ablative, scanned, nonsequential CO2 laser in the treatment of photo-damaged skin and to evaluate histologic and ultrastructural changes after the treatment.

MATERIALS AND METHODS Ten subjects with Fitzpatrick skin types I to III with photo-damaged facial skin underwent a single CO2 ablative laser treatment using a scanning handpiece in a nonsequential fractional mode. Clinical improvement and histologic and ultrastructrural changes were assessed.

RESULTS All subjects completed the study with no serious or long-term complications. Blinded evaluator and subject assessment documented improvement in cutaneous photoaging. Light microscopy revealed changes consistent with a wound repair mechanism, and electron microscopy confirmed evidence of new collagen deposition.

CONCLUSION Nonsequential scanned fractional CO2 laser resurfacing can lead to improvement in photo-damaged skin, accompanied by histologic and ultrastructural evidence of wound repair and subsequent new collagen formation.