CO2 LASER

The carbon dioxide (CO2) laser was first developed in the 1960s and remains in use today for certain medical procedures, especially those involving the skin. Its precision and effectiveness in targeting abnormal skin cells make it a valuable option in specific situations, including for some patients with extramammary Paget’s disease (EMPD).

In the treatment of EMPD, the CO2 laser can be used to perform what is known as ablation. This means it removes layers of skin tissue that contain cancerous or abnormal cells. While this method can reduce the number of EMPD cells present, it has not always been successful in completely eliminating the disease. Many patients have experienced only partial improvement, and in some cases, the disease has returned after treatment. For this reason, the CO2 laser is often considered a supportive or secondary option rather than a primary cure.

Some patients experience scarring after the procedure, which is an important consideration, particularly when the affected area is sensitive or visible. To improve results, a few patients have undergone a combination of CO2 laser ablation followed by photodynamic therapy (PDT). PDT uses a special light and a medication that makes the cancer cells more sensitive to that light. The goal of combining these therapies is to increase the chances of reducing or eliminating EMPD cells more effectively.

The extent of the EMPD area can influence how the CO2 laser treatment is delivered. When the affected area is larger or more complex, the procedure may need to take place in an operating room. In such cases, patients are often given sedation to keep them comfortable during the treatment.

Although CO2 laser therapy may not be a stand-alone solution for EMPD, it continues to play a role in the broader management of the disease for certain individuals. Patients considering this option should discuss it thoroughly with their medical team to understand the potential benefits, risks, and whether it might be most effective when combined with other treatments.

Treatments for extramammary Paget’s disease (EMPD) often differ but frequently include one or more of the following: Mohs surgery, wide local excision (WLE) surgery, topical creams, carbon dioxide (CO2) laser, photodynamic therapy (PDT), cavitational ultrasonic surgical aspiration (CUSA), radiation therapy, skin grafts, and chemotherapy.