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 u tilized for these purposes was the pulsed char-free carbon dioxide las er. These lasers, however, produce thermal damage related to prolonged wound healing. The Erbium (Er): YAG laser, with its 2940-nm wavelengt h and maximal water absorption, has been recently introduced for laser resurfacing of the facial skin. OBJECTIVE. In this study, specific pa rameters for Er:YAG laser treatment of rhytides were evaluated clinica lly and histologically. METHODS. Fifteen patients were treated with th e Er:YAG laser. Perioral, periorbital, and total face rhytides were tr eated. All patients were treated with 0.8-1.0 J, 5-mm spot size, with the final fluences of 4-5 J/cm(2). Patients were evaluated daily after treatment for 7 days and weekly for 2 months for erythema, healing ti me, improvement, and pigmentary changes. Histologic evaluation of prea uricular human facial ex vivo skin was done to determine the penetrati on of multiple passes of Er:YAG laser in human facial skin. RESULTS. A ll patients showed some degree of improvement of their rhytides. Reepi thelialization occurred between 3 and 8 days. All evidence of erythema resolved between 3 and 6 weeks after treatment. The level of tissue a blation was determined to be down to: the granular layer after one pas s; to the basal cell layer after two passes, to the papillary dermis a fter three to four passes, and deeper into the papillary and superfici al reticular dermis after five to six passes. CONCLUSION. The Er:YAG l aser plays a significant role in the treatment of superficial and mid- depth rhytides. (C) 1998 by the American Society for Dermatologic Surg ery, Inc.