Recurrence rates and long-term follow-up after laser resurfacing as a treatment for widespread actinic keratoses in the face and on the scalp

BACKGROUND: Diffuse widespread actinic keratoses (AK) are difficult to treat, have a tendency towards higher recurrence rates, and therefore require ablative treatment. Laser resurfacing is one of the treatment modalities that can treat whole surface areas. OBJECTIVE: To evaluate patients who underwent laser resurfacing for widespread AK with long-term follow-up for recurrence rates, time until new lesions occur, and the most common side effects. METHODS: Retrospective case-control study of 25 patients who underwent laser resurfacing for widespread AK on the scalp, forehead, or full face at our department. Follow-up varies from 7 to 70 months. Recurrence rates, adverse effects, and improvement were analyzed through chart analysis. RESULTS: The mean average follow-up was 39 months. Forty-four percent of the patients had no recurrence during the time period. Fifty-six percent of the patients developed new lesions after treatment, but only a few. Of the recurrences, 20% occurred within 1 year and 36% occurred after 1 year. The most common short- and long-term side effects were infections (12%), hypopigmentation (48%), hyperpigmentation (8%), acne (12%), milia (12%), scar formation (8%), and atrophic and/or easily bruising skin (20%). CONCLUSION: Laser resurfacing is an effective treatment modality for diffuse widespread AK with long-term recurrence-free intervals.

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