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. Study Design: A retrospective chart review of 24 patients with widespread facial AK's (greater than 30) treated with full face UPCO2 and/or Er:Yag laser resurfacing was performed. All patients were a minimum of 1 year postoperative 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. Lasers Surg. (C) 2004 Wiley-Liss, Inc.