Safety of laser skin resurfacing in immunocompromised and diabetic patients

Laser skin resurfacing is a common procedure in aesthetic surgery. The safety of facial laser skin resurfacing among immunocompromised and diabetic patients has not been scientifically assessed. The purpose of this investigation was to evaluate for differences in adverse events among immunocompromised patients and diabetic patients following laser skin resurfacing. A retrospective review of all patients who underwent fractionated ablative laser skin resurfacing at between 2010 and 2019 was performed. Infectious and dermatologic complications within the first 3 months after surgery were recorded and compared between immunocompetent, immunocompromised, and diabetic patients. A total of 525 cases were identified, including 22 immunocompromised, 21 diabetic, and 482 immunocompetent cases. Patient demographics were similar between groups. Infectious complications occurred in 15 (2.9%) patients: 1 (4.5%) among immunocompromised cases, 1 (4.8%) among diabetic cases, and 13 (2.7%) among immunocompetent cases, with no significant difference in incidence (P = 0.35). Fourteen infections (93.3%) occurred within the first 2 weeks of laser resurfacing. The rates of other adverse dermatologic events such as prolonged erythema, post-inflammatory hyperpigmentation, and scarring were similar between groups (P = 1.00, 0.21, 1.00, respectively). Compared to non-diabetic immunocompetent patients, no significant difference in rates of infection following laser skin resurfacing in immunocompromised patients or diabetic patients was observed. Level of evidence: Level III, risk / prognostic study.