Periorbital Post-Inflammatory Hyperpigmentation after Fractionated CO2 Laser Resurfacing in Asians

Background: Most data on laser resurfacing have come from studies of people with Fitzpatrick skin types 1 3; however, the world’s population is comprised mostly of Fitzpatrick skin types 4 6, which are more susceptible to post-inflammatory hyperpigmentation (PIH). Objective: For the purpose of expanding the expertise of plastic surgeons treating patients with darker skin types, this study examined the incidence of PIH in Asians who underwent laser resurfacing, including a histologic arm on fractional ablative resurfacing. Methods & Materials: The clinical study included six subjects of Vietnamese origin who underwent single-depth fractionated CO2 laser resurfacing. The histologic study involved a seventh subject. The MiXto SX® laser with a new scanning handpiece was used, along with magnifying loupes to assess ablative depth after each of three laser passes performed. Photographs were taken at various postoperative intervals. Results: All six clinical subjects showed cosmetic improvement in skin texture and tone with no post-inflammatory hyperpigmentation. In the histologic study, H&E stained sections revealed uniform diathermy. Conclusion: It is possible to significantly reduce PIH in darker skinned subjects through use of a new scanning handpiece and a technique using loupes to assess the depth of ablative resurfacing. The histologic study confirms these findings.