Computerized Scanning Erbiumi:YAG Laser for Skin Resurfacing

Laser skin resurfacing has become increasingly popular as a method of facial rejuvenation. Although carbon dioxide (CO2) laser resurfacing is extremely effective, there is considerable morbidity associated with this procedure. Erbium (Er):YAG lasers, like CO2 lasers, are highly absorbed by water, and are absorbed superficially in skin. In our study of 141 patients using the computerized scanning Er:YAG laser, we found that it was possible to precisely ablate skin with less thermal injury than the currently available scanning CO2 lasers. The scanning system allowed very precise and homogeneous skin ablation. It was possible to ablate epidermis and superficial dermis, although deeper resurfacing led to pinpoint bleeding. Furthermore, healing was more rapid than generally experienced using CO2 lasers. Erythema was less marked, and disappeared usually within 3-4 weeks. Histological studies confirmed the minimal degree of thermal injury, as was evident clinically. Fluences of at least 20 J/cm2 were necessary to produce new collagen formation.