Complications of Ablative Resurfacing

In this discussion, Joel Coen addresses the complications associated with ablative resurfacing procedures in dermatologic surgery. He emphasizes his experience with both fractional and full-field erbium and CO2 lasers and explains that while fractional mechanisms may lead to prolonged healing phases, full-field treatments often yield more significant aesthetic improvements. Coen stresses the importance of patient education regarding anticipated post-inflammatory erythema and skin care post-procedure, mentioning specific techniques for managing pain through nerve blocks and nitrous oxide. He highlights the potential for complications such as hypopigmentation, hyperpigmentation, and infection, often arising from patient non-compliance with post-operative instructions like consistent sunscreen application. Furthermore, he notes the rare occurrence of eruptive keratoacanthomas following resurfacing and encourages careful follow-up to monitor these and other potential side effects. Overall, he advocates for a balanced approach in combining ablative and non-ablative treatments to enhance patient outcomes while managing expectations and complications effectively.