Cosmetic laser therapy could be repurposed for localized scleroderma

Study finds treatment may help reduce skin scarring in patients
Written by Marisa Wexler, MS | January 20, 2026

​Carbon dioxide ablative fractional laser (CO2-AFL) therapy, a treatment that’s long been used to remove wrinkles, may help reduce skin scarring in people with localized scleroderma, according to a new study.

“Overall, CO2-AFL treatment appears to have good therapeutic effects in patients with [localized scleroderma], especially patients who are unresponsive to conventional treatments. Furthermore, most of the adverse effects related to this treatment were mild and manageable, indicating the favorable safety profile of CO2-AFL treatment,” researchers wrote.
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The study, “Efficacy and Safety of Ablative Fractional CO2 Laser Therapy for Localized Scleroderma: A Comprehensive Bench-to-Bedside Approach,” was published in Dermatologic Therapy.

​Scarring affects skin in localized scleroderma
Scleroderma is a disorder characterized by excessive scarring, known as fibrosis. During fibrosis, the body produces excessive levels of collagen, a structural protein that forms the main component of scar tissue. In people with localized scleroderma, this scarring affects the skin, causing patches of hardened, discolored tissue.

CO2-AFL is a procedure that uses a laser to promote the rearrangement of collagen in the skin. Essentially, the laser destroys some of the existing skin tissue to activate the body’s natural healing capabilities. CO2-AFL has been used for decades in cosmetic procedures to help remove wrinkles and make the skin appear more younger-looking. But since it can help restore normal collagen, and dysregulated collagen is a hallmark of fibrosis in scleroderma, a team of scientists in China wondered if this cosmetic procedure might be repurposed as a treatment for localized scleroderma.

The team first conducted tests in a mouse model in which fibrosis was induced by injecting a toxic chemical under the skin. The researchers found that CO2-AFL treatment reduced scarring, reduced collagen accumulation, and promoted the growth of new hair follicles.

The scientists then conducted a small clinical trial in which 34 people with localized scleroderma underwent CO2-AFL treatment once per month for three months. The procedure was generally well tolerated; some participants reported side effects, such as pain or itching related to the laser treatment, but none were severe.

Swelling in the treated area was observed shortly after treatment and resolved within a few days. Eschars, or layers of dead tissue similar to a scab, typically formed about two days after treatment and fell off within two weeks.

Following CO2-AFL treatment, measures of skin thickness, hardness, and elasticity decreased, all of which are indicative of less scarring. Clinician- and patient-rated assessments of lesion severity also showed significant improvements following the laser therapy.
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Overall, the available data support CO2-AFL as a safe and effective option to manage skin lesions in people with localized scleroderma, the researchers concluded. The scientists stressed, however, that this study was limited to a small number of patients and follow-up times were relatively short, so further work is needed to assess the long-term safety and effectiveness of this approach.