Laser excision of benign skin lesions: a comparative analysis of two CO<sub>2</sub> laser systems

Lasers are common dermatological tools used for both clinical and aesthetic indications. The CO2 laser is the gold standard system used for ablative removal of benign lesions. Due to its high absorption in water and low ablation threshold, it can be used to remove, cut, and coagulate skin tissue. This retrospective analysis compared the 3-month safety and performance of the Alma Hybrid/Hylight 50 and Pixel CO2 Focus laser systems used to remove benign skin lesions in adult patients. Treatment tolerability was rated immediately after the procedure, while clearance and patient satisfaction with treatment outcomes were assessed at the 6-month follow-up visit. Overall, 37 lesions were excised with the Hybrid/Hylight 50 laser, and 41 lesions were excised with the Pixel CO2/Focus laser. In both cohorts, 70% of the lesions removed were intradermal nevi or skin tags, all lesions were nonvascular, and most were located on the face (Hybrid/Hylight: 75.7%; Pixel CO2/Focus: 61.0%). Median lesion size was 7.65 mm and 7.09 mm in the Hybrid/Hylight and Pixel/Focus cohorts, respectively. Complete removal of all lesions was achieved after a single treatment session, regardless of the laser system used. Patients reported very low pain levels and were highly satisfied with the treatment outcomes. Hypopigmentation was reported for two patients in the Hybrid/Hylight cohort and 1 patient in the Pixel cohort; 1 patient in each cohort developed post-inflammatory hyperpigmentation. All adverse events resolved within 5-10 months. Our findings indicate that CO2 lasers can safely and effectively remove benign skin lesions of varying sizes and locations on the body.