Alabaster Skin After CO2 Laser Resurfacing: Evidence for Suppressed Melanogenesis Rather Than Just Melanocyte Destruction

Hypopigmentation is a recognized side effect of CO2 laser resurfacing. Pigment abnormalities are a major side effect of facial laser procedures and can cause much emotional distress. We report a case of a patient who, after receiving laser treatment, developed persistent hypopigmentation that has defied a variety of treatment attempts. Results of histologic and immunohistochemical studies support the hypothesis that suppressed melanogenesis rather than just destruction of melanocytes is important in the etiology of the alabaster skin side effect.