Facial resurfacing with erbium:YAG laser

New Orleans - Results of a study comparing the carbon dioxide (CO₂) laser and the dual-mode long-pulsed erbium:YAG laser for ablative facial resurfacing demonstrated that patients in the erbium:YAG laser group experienced less scarring and fewer pigmentary changes, according to John L. Burns, M.D., of Dallas Plastic Surgery Institute, Dallas.

Other advantages of the erbium laser included less heat used during the procedure, faster patient healing and quicker recovery time, investigators found. Patients also experienced less postoperative redness.

Erbium advantages

"The major advantage of the erbium:YAG laser was that we found that there is a decreased incidence of scarring and pigmentary changes using the erbium versus the CO₂," he explains.

During the ablative skin resurfacing procedure, the epidermis and part of the dermis is removed. This improves skin texture, uneven skin color, superficial blood vessels and wrinkles.

The CO₂ laser has been the gold standard for ablative facial resurfacing for many years. Dr. Burns and his colleagues A. Jay Burns, M.D., and Jane Kim, M.D., used the erbium:YAG laser (Contour, Sciton) in the study.

"We have been very satisfied with the performance of the erbium laser. One of the major advantages of using this laser is that the surgeon can program the laser to the pure ablative setting and have a combination of ablation and coagulation, which makes it more like a CO₂ laser. However, if the erbium laser is operated with pure ablation, all the heat is taken out of the laser," according to Dr. Burns.

In addition, the wavelength of this laser is much more specifically targeted to the water in the skin compared to the CO₂ laser, he says.

Results

The quick healing and shorter recovery times also make the erbium laser appealing. According to Dr. Burns, patients can expect about one-third less time with redness compared to the CO₂ treatment.

"In our experience for healing with full-face treatment using the erbium laser, the epithelium is re-established in 10 days with the erbium laser and about two weeks with the CO₂," he says.

The lasting results of treatment vary among patients. "It depends on how well the patient takes care of their skin after surgery. The aging process continues from the time of surgery, so this would be highly variable. The reduction in wrinkles would make the skin appear about 10 years younger. However, smoking, poor skincare and sun exposure would age the skin much faster," he says.

"Patients are also very pleased with the results. While the first week post-op is difficult in term of wound management, after 10 days they can go into cover-up makeup, which helps tremendously," Dr. Burns explains.