The disadvantage of ablative resurfacing is the significant downtime required during the recovery period. During the first week, erythema and edema are significant, wound care is necessary, and social activities come to a halt. Postoperative edema decreases after the first 3-4 days, whereas the erythema is prominent for the first week until re-epithelialization occurs and slowly diminishes over the next few weeks. The risk of infection, pigmentary changes and scarring is higher in the immediate postoperative period, as it is in any procedure where de-epithelialization occurs. Makeup is necessary for several weeks to months until any residual erythema and postinflamma-tory hyperpigmentation diminishes. Contact dermatitis may be more easily triggered in the postlaser disrupted epidermis, leading to pruri-tis and erythema. Acne, activated by the occlusive effect of the petrolatum or other dressings, is more common in the treated area and may take several weeks to clear. Relative hypopigmenta-tion can be seen as removal of the acquired sun damage or "actinic bronzing" returns the skin to its normal nonsun-exposed color; this underscores the need for careful blending (feathering) into any surrounding areas of untreated sun-damaged skin during the procedure. Of greater concern is the development of either permanent delayed hypopigmentation or scarring.
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