Ma. Trelles et al., Skin resurfacing improved with a new dual wavelength Er : YAG/CO2 laser system: A comparative study, J CLIN LASE, 17(3), 1999, pp. 99-104
Objective: The efficacy of a new dual wavelength Er:YAG and CO2 laser syste
m was tested for skin resurfacing results on rabbits' ears and human facial
skin. The dual wavelength laser delivers simultaneous pulses of low-energy
CO2 and high-energy Er:YAG energies, Theoretically, combining the strength
s of both laser types in one console should lead to improved clinical outco
me. Summary Background Data: The use of the laser for skin resurfacing and
remodeling has dramatically increased over the past few years. The CO2 lase
r was the first laser to be used in this field, followed more recently by t
he E:YAG laser. Both lasers offer unique advantages and disadvantages. Meth
ods: The present study consists of an ear chamber experiment, conducted on
eight rabbits, to examine vascular network formation, after laser resurfaci
ng with a standard CO2 laser and the Er:YAG/CO2 laser, Resurfacing was also
performed on human patients with the Er:YAG/CO2 laser and the results were
compared with previously published results of CO2 laser resurfacing. Resul
ts: Significant advantages, including an attenuation in the degree of edema
and erythema and a shorter reepithelialization time compared to results wi
th conventional CO2 systems, were observed with the Er:YAG/CO2 system. Impr
oved tissue reorganization and good clinical results in nine of the ten pat
ients (six ratings of "very good" and three "good") were observed. The clin
ical outcome of the remaining patient was rated as "fair," Minimal side eff
ects were reported and observed in only three patients, The learning curve
required to maximize the efficiency of the system is steep, however, requir
ing a thorough understanding of the different laser/tissue interactions ass
ociated with the two wavelengths. Conclusion: It is the authors' opinion th
at the dual wavelength Er:YAG/CO2 laser system offers a particularly effici
ent and flexible system to perform standard CO2 procedures for skin resurfa
cing with an improved clinical outcome, as well as other applications with
the CO2 or Er:YAG energy delivered separately.