Clinical advantage of the CO2 laser superpulsed mode. Treatment of verruca vulgaris, seborrheic keratoses, lentigines, and actinic cheilitis

Abstract

Background: Unintended thermal damage occurring during surgery with the CO2 laser limits its usefulness because of slow healing and increased scarring. The superpulsed mode was developed to address this problem, but little clinical data exist to evaluate its effectiveness.

Objective: Patients having warts of the hands and feet, seborrheic keratoses, lentigines, and actinic cheilitis were treated by three experienced laser surgeons using both the conventional continuous mode CO2 laser and a superpulsed CO2 laser. Effectiveness of therapy, healing time, and rates of scarring were compared for the two groups of patients.

Methods: Charts of patients treated in 1988 and 1989 were reviewed and data recorded regarding surgical parameters, healing time, scarring, and effectiveness of therapy. Patients were placed in a diagnosis category with each laser only if there was a corresponding patient treated by the same physician using the other laser.

Conclusion: The superpulsed mode was found to convey only a slight advantage. The use of a 50-millisecond pulse was even more advantageous. The superpulse parameters are analyzed and ideal parameters to prevent unwanted thermal damage are suggested.