The Er:YAG laser is producing dramatic results...

Arthur L. Millman, MD, an eye and facial plastics specialist in private practice explains:

 "Unlike hot thermal CO2 laser resurfacing, the cold erbium laser does not have a "significant recuperation period," Dr. Millman said. "That 2- to 3-month period of erythema is very difficult for patients, especially working patients, to cope with."

The erbium acts on the molecular ponds of the water within the cell. And although there are technically microscopic amounts of heat liberated, it is essentially a heat-free laser technique".

No thermal effect

"The erbium laser vaporizes the cell layers - layer by layer - without the thermal effect, so there is no burning. Without the burning, there is no redness and irritation," he said. As a result, a prolonged 2- to 3-month recovery period is reduced to 1 to 3 weeks. "It's usually closer to 1 to 2 weeks, at which point the patient is completely healed." Patients often return to work within a week.

The Er:YAG laser, however, does not penetrate as deep or treat wrinkles as heavy as is possible with the CO2 laser. On a wrinkle removal grading scale of 1 to 4 (with 4 being the deepest and heaviest), the CO2 can correct up to grade 4, whereas the erbium is limited to 1 through 3.

Ideal for younger patients

Fully healed 11 days postop. No erythema is present, and lid and cheek wrinkles are gone.  Consequently, the erbium laser is especially ideal for younger patients.

"Treatment can be repeated over the years because there is no thermal damage or scarring to the skin," said Dr. Millman, who has been using the new laser for the past year, since Food and Drug Administration (FDA) approval. There are even instances when he combines CO2 and Er:YAG treatment.