ABSTRACT
These lasers are high powered and destroy the epidermis and simultaneously heat the dermis causing collagen to shrink. The resultant wound inicted in the skin heals with remodelling of the ECM and new smoother, tighter skin is formed. The supercial dermis and entire epidermis is coagulated and ablated to a depth of around 150 – 300 microns (Tournas and Zachary 2010; Stewart et al. 2013). The most commonly used ablative lasers include the CO2 (10,600 nm) laser, Er:YAG laser (2,940 nm) and erbium-doped yttrium scandium gallium garnet (Er:YSGG) laser (2,790 nm). The CO2 laser results in rapid heating and vaporization. Localized tissue coagulation and protein denaturation results in haemostasis and later on skin tightening. It could take up to several months to achieve the desired effects, but the improvements in wrinkles and scarring is clinically signicant (Stewart et al. 2013). The Er:YAG laser is absorbed 10-16 times more by water than the CO2 laser, resulting in more supercial ablation which reduces healing time as well as patients tolerance. However associated with this is reduced haemostasis and a reduction in tissue remodelling and skin tightening due to loss of dermal heating (Stewart et al. 2013).
