Skin resurfacing of the face with the Erbium:YAG laser.

BACKGROUND: Laser resurfacing of facial skin is a very popular method of rhytide and scar removal. Until recently, the most effective tool utilized for these purposes was the pulsed char-free carbon dioxide laser. These lasers, however, produce thermal damage related to prolonged wound healing. The Erbium (Er): YAG laser, with its 2940-nm wavelength and maximal water absorption, has been recently introduced for laser resurfacing of the facial skin.

OBJECTIVE: In this study, specific parameters for Er:YAG laser treatment of rhytides were evaluated clinically and histologically.

METHODS: Fifteen patients were treated with the Er:YAG laser. Perioral, periorbital, and total face rhytides were treated. All patients were treated with 0.8-1.0 J, 5-mm spot size, with the final fluences of 4-5 J/cm2. Patients were evaluated daily after treatment for 7 days and weekly for 2 months for erythema, healing time, improvement, and pigmentary changes. Histologic evaluation of preauricular human facial ex vivo skin was done to determine the penetration of multiple passes of Er:YAG laser in human facial skin.

RESULTS: All patients showed some degree of improvement of their rhytides. Reepithelialization occurred between 3 and 8 days. All evidence of erythema resolved between 3 and 6 weeks after treatment. The level of tissue ablation was determined to be down to: the granular layer after one pass; to the basal cell layer after two passes, to the papillary dermis after three to four passes, and deeper into the papillary and superficial reticular dermis after five to six passes.

CONCLUSION: The Er:YAG laser plays a significant role in the treatment of superficial and mid-depth rhytides.