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When talking about a technique that can address almost every issue regarding skin complexion Fractional Laser Skin Resurfacing (Er:Yag 2490nm) comes into play. What is Erbium Laser? Erbium laser is a laser used on the skin with a wavelength of 2940nm. It targets the water in the skin. It vaporises the tissue in a controlled manner on the skin’s surface. It can be used in the treatment of wrinkles, acne scarring, skin texture, pigmentation
What conditions is Erbium Laser used for?
Wrinkles: Erbium laser can be used for mild to moderate wrinkles. It is used for resurfacing the skin. The laser ablates the skin surface to a chosen depth. Several passes can be used. The range of depths can include anywhere from 10 microns to 120 microns. The deeper the treatment, the greater the results and the greater the downtime and potential complications. Downtime can range from 5 days to 2 weeks To improve skin texture and the appearance of pores: Removing the top 10-30 microns is a light resurfacing procedure and will require 5 days downtime. The uppermost layer of skin is removed and a brand new skin surface is created. This will stimulate collagen and the skin will appear refreshed
Pigmentation: Superficial pigmentation may be removed with an erbium laser, by vaporising the tissue on the surface of the skin where the pigmentation resides. In general it is better to use a laser or IPL that targets the pigment to remove pigmentation while keeping the skin surface intact. The Erbium laser does not keep the surface of the skin intact.
Acne scarring treatment: Acne scarring may be treated by ablating the superficial layers of the skin. New skin is formed and collagen is regenerated and a smoother texture of the skin will occur Rhinophyma treatment: rhinophyma is a enlargement of the nose and its skin tissue, which can occur as part of Rosacea. It is due to enlargement of sebaceous glands of the nose. It can cause an unsightly lumpy and bulbous appearance of the nose. The erbium laser can be used to remove the excess nose tissue, improving the nose shape and skin texture.
What are the side effects/risks of Erbium Laser?
Hyperpigmentation / PIH (Post inflammatory hyperpigmentation) Increased skin pigmentation. This tends to occur in patients with darker skin tones. If a patient is predisposed to PIH, then they should be on a lightening agent prior to and after treatment to reduce the likelihood of PIH occurring. Topical steroid may also be prescribed by the doctor after the treatment to reduce the likelihood of PIH Hypopigmentation (decreased skin pigmentation) This is possible after Erbium laser. The deeper the treatment, the greater the likelihood of this occurring. This is uncommon in full facial resurfacing at mild to moderate depths. Hypopigmentation in a very small area is likely when removing a deep benign mole/naevus.
Scarring: Very uncommon
Infection: Cold sore (herpes virus) and bacterial infections are possible. Antivirals may be prescribed preventatively. Antibiotics may be required if a bacterial infection occurs
Acne erruption: This can occur after the procedure possibly due to the greasy ointment which is required for healing. It usually resolves quite quickly.
THE PROCEDURE FOR FULL FIELD ERBIUM LASER
Fractional Laser Skin Resurfacing Consultation: Consultation is required before fractional resurfacing treatment. A history will need to be taken, including history of other treatments, complications, skin type and history of cold sores. The amount of downtime available will need to be discussed and also other treatment options Examination of your skin and what needs to be required. Photographs of your skin will be taken.
Consent form will be read and signed, with opportunity for further discussion If the patient is predisposed to PIH, a lightening agent would be prescribed. Sometimes this is required for up to 8 weeks prior to procedure The patient may be prescribed a retinoid to prepare the skin for resurfacing.
Appointment will be made for the procedure. Prepayment is required The Erbium Laser Procedure The patient arrives 1 hour before the procedure and may be given some Valium prior to the procedure. This is not required for single spot erbium or nano laser peels, or micro laser peels Local anaesthetic may be injected to block the nerves A topical anaesthetic will be applied for 30 min prior to the procedure. The patient’s face will be cleaned twice with medical grade cleansers.
The Erbium laser will be used on the face with multiple pulses to pass over the face. Several passes over the face may be required An ointment will be applied to the face eg Aquaphor The patient’s face will be very red and covered in a layer of ointment.
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