Five Years Out: What New Data on Fractional Laser Resurfacing Reveals About Skin Cancer Prevention

Actinic keratosis — the rough, scaly patches that form after years of cumulative UV exposure — affects an estimated 58 million Americans, and a subset of untreated lesions progress to squamous cell carcinoma each year. For more than two decades, researchers have asked whether ablative fractional resurfacing, the laser category CO2 treatment belongs to, does more than clear existing sun damage — whether a single treatment might also lower the odds of new precancerous and cancerous lesions forming afterward. A closely watched randomized controlled trial addressing that exact question has been running long enough that researchers just published five-year follow-up data on the same patient cohort, a notable milestone for this kind of research. Here's what the trial's well-documented data already show, why the extended follow-up matters, and how it relates to CO2 laser resurfacing specifically.

How the Trial Was Designed

The research, led by dermatologist David Ozog and colleagues and originally published in JCI Insight in 2021, enrolled 48 adults ages 60 to 87 (47 men, one woman) with visibly sun-damaged forearms and hands. The design was a randomized, single-blinded, split-body trial: each participant received one treatment with an ablative fractional erbium-doped yttrium scandium gallium garnet (Er:YSGG) laser at 2790 nm on one forearm, while the opposite forearm went untreated as an internal control. Outcomes were tracked at regular intervals through 36 months in the original paper.

The Numbers Behind the Headlines

The results were substantial. The ratio of actinic keratosis lesions on treated versus untreated forearms fell from 1.32 at baseline to 0.37 within three months of the single treatment — a highly significant shift (p < .0001) — and stayed suppressed through the full 36-month window. More strikingly, the trial tracked actual skin cancer diagnoses, not just precancerous lesion counts:

• Trial size: 48 adults ages 60-87, one treatment per participant, randomized split-body design (one forearm treated, the other untreated as control)

• Device studied: ablative fractional Er:YSGG laser at 2790 nm, roughly 120 mJ per microspot

• Precancerous lesions: AK ratio (treated:untreated) dropped from 1.32 to 0.37 by 3 months and stayed low through 36 months

• Skin cancer outcomes over 3 years: 24 new nonmelanoma skin cancers on untreated arms vs. 2 on treated arms - roughly a fourfold difference

• Cancer types reduced: invasive squamous cell carcinoma, SCC in situ, and basal cell carcinoma all occurred less often on treated skin

• Safety: no scarring reported; crusting resolved within about 2 weeks, redness within about a month

• 2026 update: the same 48-person cohort has now been followed for 5 years total (Journal of the American Academy of Dermatology), one of the longest tracked outcomes for a single resurfacing treatment on record

Why the Five-Year Follow-Up Matters

Extending observation on this same cohort to five years is notable in itself — few laser-based prevention studies track patients this long after a single treatment, and the extension reflects sustained interest in whether one procedure can meaningfully affect skin cancer risk for years rather than months. Researchers have proposed the original effect works through more than simple lesion removal: theorized mechanisms include increased dermal IGF-1 signaling and clearance of UV-damaged senescent fibroblasts, effectively changing how aged skin responds to future sun exposure. Even so, the trial has real limits worth naming — it tested one device on forearms in a small, mostly male cohort, not full-face treatment with every ablative fractional wavelength, so results shouldn't be generalized beyond what was actually studied.

What This Means for CO2 Laser Resurfacing

CO2 laser, delivered at 10,600 nm, and the Er:YSGG device used in this trial both fall under the ablative fractional resurfacing umbrella — both create controlled columns of micro-injury that trigger a dermal remodeling response, just at different wavelengths and depths. That shared mechanism is part of why this research is worth following for anyone considering CO2 resurfacing for sun damage, even though CO2 specifically hasn't been studied for this cancer-prevention endpoint. CO2 treatment at Cor.e Laser Studio is offered to improve texture, tone, and visible sun damage — not as a substitute for dermatologic skin cancer screening or treatment.

Common Questions

Does this study prove laser resurfacing prevents skin cancer for everyone who gets it? Not on its own. This is one randomized trial with 48 participants, tested exclusively on forearms and hands with a specific device. It's a meaningful signal worth watching, not a general clinical guarantee, and larger trials on other body areas and devices would be needed before that claim could be made.

Was CO2 laser the device studied here? No. Researchers used an ablative fractional Er:YSGG laser at 2790 nm, a different wavelength than the 10,600 nm CO2 laser used at Cor.e. Both fall into the same ablative fractional resurfacing category and share a similar mechanism, but CO2 specifically hasn't been studied for this skin-cancer-prevention endpoint.

If I've had laser resurfacing, can I skip my yearly skin cancer check? No. An annual skin exam with a dermatologist remains the standard for catching skin cancer early, regardless of laser history. This research doesn't change that recommendation.

Does Cor.e Laser Studio screen for or treat skin cancer? No. Cor.e offers CO2 laser resurfacing and IPL specifically to improve skin texture, tone, and visible sun damage. Skin cancer screening and treatment should always go through a dermatologist or physician.

Research like this is a reminder of how much is still being learned about the ablative fractional resurfacing category that CO2 laser belongs to. If sun damage, uneven tone, or rough texture is what brought you here, a free consultation at Cor.e Laser Studio can help determine whether CO2 resurfacing or IPL is the right fit for your skin. Call 719-350-4466 or book online — and keep your regular dermatologist skin checks on the calendar either way.