ABSTRACT
Previous studies with CO2 lasers demonstrate that this modality ablates approximately 100 µm of skin, leaving an additional 50-300 µm of collateral thermal damage.1-3 This thermal damage promotes collagen contraction and remodeling.4-6
(1) Laser resurfacing with either sequential CO2 and Er:YAG lasers; a combined Erbium:YAG/CO2 laser; or a variable pulsed Erbium:YAG laser can achieve clinical and histologic results equivalent to that seen with CO2 laser resurfacing
(2) Laser resurfacing with either sequential CO2 and Er:YAG lasers; a combined Erbium:YAG/CO2 laser; or a variable pulsed Erbium:YAG laser may lead to a decreased amount and greater control of thermal injury
(3) Clinical studies using either sequential CO2 and Er:YAG lasers; a combined Erbium:YAG/CO2 laser; or a variable pulsed Erbium:YAG laser demonstrate decreased post-treatment time to complete re-epithelialization, compared to CO2 laser treatment
(4) Clinical studies with a combined Erbium:YAG/CO2 laser demonstrate decreased time to complete resolution of post-operative erythema
(5) Clinical studies with a combined Erbium:YAG/CO2 laser demonstrate decreased occurrence of clinically significant or permanent post-operative hyperpigmentation and hypopigmentation
Studies with short-pulsed Erbium:YAG (Er:YAG) lasers, with their higher water absorption rate and shorter pulse duration than CO2 lasers, demonstrate tissue ablation of 20 to 40 µm with each pass, and collateral thermal damage of 5 to 30 µm (see Chapter 4).10,11 This amount of tissue ablation and thermal damage is typically much less than that seen with CO2 laser resurfacing.
