Ablative lasers remove the top layers of the skin (epidermis) and heat the layer under the epidermis (the papillary dermis). This causes collagen (a substance that gives skin structure) regeneration. As the wound caused by the laser heals, smoother and more even skin is seen. There are three types of ablative lasers used for resurfacing: carbon dioxide (CO2), erbium:YAG (Er:YAG) and the long-pulsed erbium:YAG.
In contrast to the previous version of CO2 lasers, the newest generation of pulsed CO2 lasers delivers short bursts of extremely high-energy laser light. This revolutionary technology actually vaporizes the undesired skin tissue one layer at a time, revealing fresh skin underneath. Often referred to as a pulsed CO2 laser, the laser’s highly focused beam enables the dermatologic surgeon to gently remove the skin’s surface with a lower risk of scarring and other complications in properly selected patients. Healing generally occurs over a two-month period.
The high-powered Er:YAG laser produces energy in a wavelength that gently penetrates the skin, is absorbed by water (a major component of tissue cells), and scatters the heat effects of the laser light. These unique properties allow dermatologists to remove thin layers of skin tissue with exquisite precision while minimizing damage to surrounding skin.
The Er:YAG laser is commonly used for skin resurfacing in patients who have superficial to moderate facial wrinkles, mild surface scars, or skin discoloration. The gentle touch of the Er:YAG laser means it is uniquely effective in rejuvenating sun-damaged skin in areas such as the delicate skin around the eyes and mouth, where other lasers may cause scarring. Other body areas, such as the neck and hands, also may be considered for treatment with the Er:YAG laser. Skin rejuvenation with the Er:YAG laser may offer the advantages of reduced redness, decreased side effects, and rapid healing – about 5-7 days.
A new generation of long-pulsed laser delivers results that fit in between those of the CO2 and the Er:YAG. The long-pulsed erbium:YAG laser provides more wrinkle relief and offers a reduced risk of scarring compared to both. However, with less heat to the skin, results may not be as striking.