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Safety of laser skin resurfacing in immunocompromised and diabetic patients

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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.

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De-identified patient data can be provided if necessary, upon request.

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Authors and Affiliations



N.A.H., V.D.D., and T.N. were responsible for project conceptualization and study design. G.A.C., N.A.H., and A.A.A. were responsible for chart review and primary data collection. G.A.C., N.A.H., and A.E. were responsible for data analysis, results interpretation, and results presentation. The manuscript was prepared by G.A.C. and N.A.H. and thoroughly reviewed and revised by all other authors.

Corresponding author

Correspondence to Natalie A. Homer.

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Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Institutional review board approval (#2020–01-0032) was acquired from the University of Texas at Austin.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Patient consent

Patients signed informed consent regarding publishing their data. All patients whose clinical photos were included in the manuscript provided both written and verbal confirmation of their consent for publication.

Conflict of interest

Vikram D. Durairaj: consultant for Stryker, Genentech, and Horizon Therapeutics. Tanuj Nakra: shareholder of Global Beauty Science, Inc. The remaining authors have no disclosures. None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript.

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Campagna, G.A., Homer, N.A., Artymowicz, A. et al. Safety of laser skin resurfacing in immunocompromised and diabetic patients . Eur J Plast Surg 45, 117–131 (2022).

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