BACKGROUND. Adult colloid milium is a rare cutaneous deposition disorder that frequently involves areas of chronic sun exposure, especially the face and dorsal hands. Attempts to remove these lesions are generally unsuccessful, but dermabrasion has been reported to be effective. OBJECTIVE. To present an effective therapeutic alternative to dermabrasion for facial colloid milium. METHODS. A 41-year-old man with extensive facial colloid milium underwent full-face resurfacing with a long-pulsed Er:YAG laser (9.8 J/cm2, 5 mm spot, 10-msec pulse duration). Additional passes were performed over the areas of dense colloid milium to achieve approximately 80% ablation of lesions. RESULTS. At the 7-month follow-up there was no scarring, textural changes, dyspigmentation, or clinical evidence of recurrence. CONCLUSION. Long-pulsed Er:YAG laser should be considered an effective alternative to dermabrasion for facial colloid milium.
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