Purpose: While histology remains the "gold standard," high-frequency ultrasound has the advantage of being a non-invasive means to evaluate skin changes in a sequential fashion in vivo. The most consistent finding has been the appearance of a subepidermal low-echogenicity band (SLEB) associated with a history of cumulative sun exposure. As CO2 laser resurfacing has gained prominence in the treatment of fine wrinkles, histological studies have also become available to demonstrate the reorganization of dermal collagen after laser treatment. Sequential ultrasonic evaluations may be able to provide baseline information of the healing of controlled facial burns more efficiently.

Methods & Materials: Case studies with sequential 20 MHz ultrasonic imaging of facial locations (forehead, crow's feet, eyelids, cheeks, and perioral area) at preoperative and immediate, one day, one week, one month, and two month postoperative time periods. Digital photography was also performed for clinical correlation at these time intervals.

Results (preliminary): Diminution of SLEB with replacement by dermal fibrotic repair zone

Conclusions: High-frequency ultrasound is a useful tool to evaluate the early in vivo changes of the skin as it recovers from CO2 laser resurfacing. In time, the hypodense subepidermal layer is gradually replaced by the deposition of new hyperechoic elastic fibers.