A Retrospective Cohort Study of fractional laser resurfacing in adult dermatology patients with atopic dermatitis

Bo Chen; W. Xu; M. Huang

doi:10.5281/zenodo.22814439

Authors

Bo Chen Department of Clinical Dermatology, Guadalquivir Institute of Cosmetic and Aesthetic Surgery Author https://orcid.org/5941-8684-9608-0216
W. Xu Department of Dermatology, Po Academy of Cosmetic and Aesthetic Surgery Author https://orcid.org/9013-9001-8172-540X
M. Huang Department of Clinical Dermatology, Parana Research Center for Dermatology Author https://orcid.org/1343-7400-1138-4566

DOI:

https://doi.org/10.5281/zenodo.22814439

Keywords:

atopic dermatitis, fractional laser resurfacing, retrospective cohort study, skin barrier, post-inflammatory hyperpigmentation

Abstract

Graphical abstract

Background: Fractional laser resurfacing is widely used to treat dyspigmentation and textural scarring, but its efficacy and safety in adult patients with atopic dermatitis (AD), whose epidermal barrier is intrinsically impaired, has not been well characterized.

Objective: To evaluate outcomes and adverse events of fractional laser resurfacing performed in adult AD patients treated for post-inflammatory dyspigmentation and textural scarring at a single academic practice.

Methods: We conducted a retrospective cohort study of adults with confirmed AD who underwent non-ablative or ablative fractional resurfacing between 2019 and 2023, with 12 months of follow-up. Outcomes included SCORAD, EASI, quality of life, transepidermal water loss, and adverse events.

Results: Among 126 patients contributing 341 sessions, mean SCORAD fell from 28.4 to 14.7 and EASI from 9.8 to 4.9 at 12 months (both p<0.001), with moderate-to-marked improvement in dyspigmentation and texture in 78% of patients. Transepidermal water loss decreased rather than worsened. Prolonged erythema and hyperpigmentation were more common with ablative treatment and darker phototypes, and flare was over four times more frequent without stable background therapy.

Conclusions: Fractional resurfacing achieved efficacy comparable to non-atopic cohorts when performed in AD patients with disease brought to quiescence beforehand, with complication risk concentrated in ablative modality, darker phototypes, and unstable disease control, identifying these as the principal levers for safe patient selection.

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