The erbium: YAG laser: a review and preliminary report on resurfacing of the face, neck, and hands

Abstract

The use of short-pulsed or flash-scanned CO(2) lasers to resurface skin has rapidly joined chemical peels and dermabrasion as an accepted procedure. The purpose of this study was to evaluate a mid-infrared pulsed Erbium: YAG laser prospectively to determine its clinical efficacy for resurfacing of the face, neck, and hands. Postoperative changes and recovery period were also evaluated. A total of 21 patients were evaluated on a prospective basis with Er: YAG laser resurfacing (12 crow's feet, five upper lips, three hands, and one neck). Additional nonstudy clinical experience is also reported. Posttreatment crusting or scabbing lasted an average of 2.7 days, pain an average of 3 days, erythema an average of 5.2 days, and swelling an average of 3 days. Blinded subjective grading was performed 2 months postoperatively. This grading revealed a 52% combined improvement from all areas. The appearance of crow's feet was improved by 58%; upper lip, 43%; dorsal hand, 48%; and neck, 44%. Overall the Er: YAG laser consistently produced reduction in rhytids and improvement in the appearance of sun-damaged skin. The times for reepithelialization and duration of erythema were strikingly shorter than those typically observed with current CO(2) laser resurfacing. This report details the study, reviews Er: YAG laser technology, and compares our findings with those observed with standard CO(2) laser resurfacing.