Full face laser resurfacing: therapy and prophylaxis for actinic keratoses and non-melanoma skin cancer.
BACKGROUND
Although there are many effective treatment modalities for individual actinic keratoses (AKs), widespread lesions on the photoaged face pose a challenge due to inefficient and ineffective therapy resulting in high rates of recurrence after local destruction. Full face laser resurfacing offers an effective and efficient treatment option that successfully reduces the number of AK's on diffusely damaged skin and may show a prophylactic benefit for preventing non-melanoma skin cancers.


OBJECTIVE
To assess the efficacy of full face laser resurfacing in reducing the number of facial AK's by comparing preoperative and postoperative numbers of lesions present and to observe the incidence of non-melanoma skin cancer after full face laser resurfacing.


METHODS
A retrospective chart review of 24 patients with widespread facial AK's (greater than 30) treated with full face UPCO(2) and/or Er:Yag laser resurfacing was performed. All patients were a minimum of 1 year post-operative following facial laser resurfacing. The recurrence of AK's and the occurrence of facial non-melanoma skin cancers in these patients was assessed through chart analysis.


RESULTS
Widespread AK's were effectively eliminated in all patients. Twenty-one patients (87%) remained lesion free for at least 1 year. Fourteen of the 24 patients (58.3%) showed no new lesions during a 2-year follow-up. There was an overall 94% reduction in total number of AK's. Adverse effects included transient perioral scarring in one patient, S. aureus infection in two patients, and dyschromia in two patients.


CONCLUSIONS
Full face laser resurfacing provides long-term effective prophylaxis against AKs and may reduce the incidence of AK related squamous cell carcinoma.
Skin and Laser Surgery Center of La Jolla, Dermatology Associates of San Diego County, Inc., San Diego, California, USA.
Shilesh
S
Iyer
Andre
A
Friedli
Leyda
L
Bowes
Greg
G
Kricorian
Richard E
RE
Fitzpatrick
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002245:Carbon Dioxide; D002280:Basal Cell Carcinoma / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005148:Facial Dermatoses / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007642:Keratosis / Q000517:prevention & control*; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055502:Secondary Prevention; D012878:Skin Neoplasms / Q000601:surgery*; D016896:Treatment Outcome
D002245:Carbon Dioxide