Fractionated Laser Skin Resurfacing Treatment Complications: A Review


Address correspondence and reprint requests to: Tina S. Alster, MD, Washington Institute of Dermatologic Laser Surgery, 1430 K Street, NW Suite 200, Washington, DC 20005, or e-mail:


BACKGROUND Fractional photothermolysis represents a new modality of laser skin resurfacing that was developed to provide a successful clinical response while minimizing postoperative recovery and limiting treatment complications.

OBJECTIVES To review all of the reported complications that develop as a result of fractional ablative and nonablative laser skin resurfacing.

METHODS A literature review was based on a MEDLINE search (1998–2009) for English-language articles related to laser treatment complications and fractional skin resurfacing. Articles presenting the highest level of evidence and the most recent reports were preferentially selected.

RESULTS Complications with fractional laser skin resurfacing represent a full spectrum of severity and can be longlasting. In general, a greater likelihood of developing post-treatment complications is seen in sensitive cutaneous areas and in patients with intrinsically darker skin phototypes or predisposing medical risk factors.

CONCLUSIONS Although the overall rate of complications associated with fractional laser skin resurfacing is much lower than with traditional ablative techniques, recent reports suggest that serious complications can develop. An appreciation of all of the complications associated with fractional laser skin resurfacing is important, especially given that many of them can be potentially prevented.

The authors have indicated no significant interest with commercial supporters.