Low risk of postinflammatory hyperpigmentation in skin types 4 and 5 after treatment with fractional CO2 laser device.

BACKGROUND/OBJECTIVE Hyperpigmentation occurs in more than 37% of dark-skinned subjects treated with a fully ablative CO2 laser device. This study assessed the risk of postinflammatory hyperpigmentation (PIH) in subjects with skin types 4 and 5 treated once with a specific protocol of treatment using a fractional CO2 laser. METHODS Seven subjects with photodamaged skin received a single facial treatment using a fractional CO2 laser. Anesthesia was limited to a lidocaine and prilocaine cream for 1 hour before the single-pass treatment. Subjects were evaluated for improvement and PIH on alternate days for 14 days, and at 1 month, 3 months, and 6 months posttreatment. RESULTS All subjects achieved improvement in their specific skin conditions and in skin texture. Postinflammatory hyperpigmentation was not observed in any subject. Four subjects experienced no pain during treatment, while 3 reported mild pain. Recovery was associated with minimal pain and itching. CONCLUSION In dark-skinned subjects, fractional CO2 laser treatment and topical anesthesia subjectively improves common skin conditions without PIH.