Short-pulse carbon dioxide laser resurfacing of the neck

Background: Carbon dioxide (CO2) laser resurfacing of the face has become an increasingly popular procedure. However, laser resurfacing of the neck has been largely avoided because of fears of scarring or pigmentation changes. Objective: Our purpose was to evaluate the efficacy of treatment and incidence of complications after short-pulse CO2 laser resurfacing of the neck. Methods: A total of 308 patients received concomitant face and neck CO2 laser resurfacing. A 90 -μs pulse duration CO2 laser without a scanner was used in all cases for 2 passes on the neck (10.6-μm wavelength, 500-mJ pulse energy, 90-μs duration, 3-mm spot size) and a continuous CO2 laser with a computer-generated scanner (396-μs dwell time, 18 W) was used for 3 passes over the face except for the perioral area, which received 4 passes. The incidence of scarring or permanent pigmentation changes was determined. Forty patients who had been treated at least 6 months but no longer than 18 months earlier were randomly surveyed by phone to assess the degree of improvement. Results: Of the 308 patients treated, there were no cases of scarring or permanent pigmentation changes. Surveyed patients reported a 39% improvement in rhytides and tightening on the neck. Conclusion: Resurfacing of the neck can be performed safely in conjunction with resurfacing of the face. Patients may be offered improvement in the neck with little chance of scarring or permanent pigmentary changes when resurfacing on the neck is performed by means of a short-pulse duration laser for a limited number of passes instead of the more aggressive laser parameters previously used such as continuous long-pulse duration treatments. (J Am Acad Dermatol 2000;43:72-6.)