Re-epithelialization of the skin following CO2 laser resurfacing.

Wound healing following CO(2) laser resurfacing of the face is a complex process which must involve a rapid replacement of the ablated epidermis to protect the underlying structures in the skin from desiccation and deeper injury. The majority of cells that regenerate the epidermis come from the hair follicles, and cell movement out of the follicles is monitored using immunofluorescence with antibodies to keratin 17, an intermediate filament protein expressed in the migrating front of cells. This migration is enhanced with occlusive dressings used immediately after the resurfacing procedure. Skin biopsies have been examined at multiple time points following resurfacing, and re-epithelialization begins by 48 h in skin that has been occluded. Skin that has been left open with no treatment forms an eschar and has no keratinocyte migration at 48 h, thus displaying delayed wound healing.