Who is not suitable for co2 fractional laser?

CO2 fractional laser treatment is a powerful skin resurfacing tool, but it carries risks that make it unsuitable for several groups of people. Suitability is often categorized into absolute contraindications and relative contraindications.

1. People below are generally advised to avoid the procedure entirely due to high risks of severe complications:

1) Active infections: Anyone with an active bacterial, fungal, or viral infection (such as active herpes simplex or cold sores) in the treatment area.

2) Recent isotretinoin use: Those who have taken isotretinoin (Accutane) within the last 6 to 12 months. Use of this medication significantly increases the risk of poor wound healing and permanent scarring.

3) Severe immunosuppression: People with compromised immune systems are at a much higher risk of life-threatening infections and delayed healing.

4) Active autoimmune diseases: Conditions like systemic lupus erythematosus or scleroderma can interfere with the body's ability to repair skin tissue safely.

5) Active cancer: Patients currently undergoing treatment for oncological diseases.

2. People below may do the treatment but require careful medical evaluation or specialized protocols:

1) Darker skin tones: People with deep skin of color have a significantly higher risk (up to 30%) of post-inflammatory hyperpigmentation (PIH) or permanent hypopigmentation (lightening of the skin).

2) Active inflammatory skin conditions: This includes active cystic acne, eczema, psoriasis, or rosacea flare-ups in the treatment area.

3) Pregnancy and breastfeeding: Elective laser procedures are universally discouraged during this time due to hormonal changes that can lead to unpredictable healing and lack of safety data.

4) History of keloid scarring: Individuals prone to keloid or hypertrophic (raised) scars are at high risk for abnormal scarring after the laser's thermal injury.

5) Recent sun exposure or tanning: Tanned skin—whether from the sun, tanning beds, or self-tanners—is more susceptible to burns and pigmentation issues.

6) Use of certain medications: Those taking anticoagulants (blood thinners) may experience excessive bleeding or bruising.