New Lasers for Skin Resurfacing — Erbium: YAG/CO₂ Systems

ABSTRACT

Skin remodeling is an important component of facial rejuvenation. For decades, chemical peeling and dermabrasion has been practiced to achieve this purpose, but lack of precision has been a major drawback. Carbon dioxide (wavelength 10,600 nm) laser resurfacing was introduced in the hope of achieving more predictable skin rejuvenation. Although many of the results produced by the carbon dioxide laser were clearly excellent, the morbidity and side effects due to thermal injury limited its use in aesthetic surgery. The Erbium: YAG (wavelength 2940 nm) laser was introduced in an attempt to achieve greater precision in skin remodeling without the nonspecific thermal effects, thereby leading to lower morbidity and fewer complications. Because the Erbium: YAG laser has a greater affinity (10 times) for water than the carbon dioxide laser, more accurate and stepwise control of the depth of epidermal and dermal destruction is possible. Furthermore, the Erbium: YAG laser is capable of producing its own target tissue, such as water within the dermis, as it stimulates the release of a transudate from dermal blood vessels. This allows true and precise ablation of dermal tissues, a phenomenon which the carbon dioxide laser is incapable of producing.

Long-term (greater than 1 year) results in over 700 patients using the Erbium: YAG laser, demonstrate that this laser can eradicate both superficial and deeper rhytids and can be safely used in all skin types in both males and females, and all age groups. The results with acne scarring and cutaneous pigmentary abnormalities have also been extremely satisfactory. The morbidity and complications have been minimal compared to the carbon dioxide laser and patient satisfaction greatly enhanced.

Keywords

Erbium: YAG - ablation - transudate - water affinity