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Wang Hui, Wu Qiuju, Wu Yule, Guo Lifang, Ge Yiping, Wang Qianqiu�� Lin Tong. Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China Corresponding author: Lin Tong, Email: ddlin@hotmail.com ��Abstract�� Objective To estimate the clinical efficacy and adverse effects of ultrapulse carbon dioxide laser for the treatment of facial angiofibroma in tuberous sclerosis patients, and to observe the recurrence of facial angiofibroma in the patients after treatment with ultrapulse carbon dioxide laser. Methods Thirty-six tuberous sclerosis patients with facial angiofibroma were enrolled in this study. Ultrapulse carbon dioxide laser ��Ultrapulse Encore�� was used for the treatment of facial angiofibroma in these patients. Laser parameters were selected according to the type of skin lesions. Results Finally, 28 patients who received single irradiation treatment and completed 6-month follow up were evaluated for efficacy and safety. Of the 28 patients, 10 were cured, 10 showed marked response, 5 response, 3 no response, and 18 experienced recurrence, with the response rate, marked response rate and recurrence rate being 89.3%, 71.4% and 64.3% respectively. Patients with a relatively small number of sparsely distributed primary lesions showed a relatively good response. There was no significant correlation between the response rate and patients′ age, gender or medical history ��all P > 0.05��. No permanent pigmentation, depigmentation, atrophy or hyperplastic scar was observed in any of these 36 patients. Conclusions Ultrapulse carbon dioxide laser is effective for the treatment of facial angiofibroma in tuberous sclerosis patients with few adverse effects but high recurrence risk. There seems to be a relatively good response to ultrapulse carbon dioxide laser in patients with a small number of primary lesions.