Laser resurfacing of smallpox scars.
BACKGROUND
At the beginning of the twentieth century, smallpox affected every continent and country in the world, but over the first half of the twentieth century this disease was eliminated in most countries, including Korea, thanks to the World Health Organization's eradication program. Most survivors of smallpox have facial scars with a distinct cobblestone appearance. Though most smallpox scar patients want smooth skin, it is difficult to achieve good results with dermabrasion or chemical peeling. Recently, with advances in laser technology, laser resurfacing has become more effective and safer than conventional methods because of its depth control precision.


METHODS
Between September of 1996 and August of 2001, 76 patients with significant smallpox scars were treated with a high-powered carbon dioxide laser at Korea University's Anam Medical Center. Different resurfacing methods, such as even-depth resurfacing, the shoulder technique, and the laser punch-out method, were applied according to the depth and pattern of the scars.


RESULTS
The authors found that 54 patients (71 percent) had excellent or good results. The sharply demarcated margins of the smallpox scars faded out, and the depth and width of the depressed scars improved in most patients. Only seven patients sustained hypertrophic scarring after laser resurfacing, but this was resolved by intradermal triamcinolone injections. Prolonged erythema occurred in six patients (7.9 percent) and hyperpigmentation occurred in 15 (19.7 percent), but the erythema disappeared spontaneously and the hyperpigmentation could be readily managed with postoperative skin care.


CONCLUSIONS
Laser resurfacing was found to be a useful treatment method for smallpox scarring.
Department of Plastic and Reconstructive Surgery, Korea University Medical Center, Seoul, Korea.
Dong Hee
DH
Kang
Seung Ha
SH
Park
Sang Hwan
SH
Koo
D000368:Aged; D002245:Carbon Dioxide; D002921:Cicatrix / Q000209:etiology / Q000601:surgery*; D017439:Cicatrix, Hypertrophic / Q000209:etiology; D005145:Face; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012899:Smallpox
D002245:Carbon Dioxide