Er : YAG laser resurfacing using combined ablation and coagulation modes

Background. The two main laser types used in resurfacing, the CO2 and the E r:YAG lasers, have their supporters and detractors, and each system has cle ar advantages and disadvantages. Objective. The Er:YAG laser can be used in the usual efficient ablative mode, followed by reprogramming to achieve no nablative deeper dermal coagulation associated with the CO2 laser, thereby achieving the main advantages of both laser types. Patients and methods. Twenty-three female patients, ages 42-72 yrs, skin ty pes I-IV, were treated. The epidermis was first removed in the ablative set tings in a single pass with 50% overlap. The Er:YAG laser was reprogrammed for the subablative mode, and several passes produced controlled residual t hermal damage (RTD) without further ablation. Results. At 2 months postresurfacing the results were assessed. Thirteen pa tients were rated "very good," eight as "good," and two as "fair." Conclusion. The dual mode Er:YAG laser can first be used in the ablative mo de to remove the epidermis with minimal RTD, following which, in the subabl ative mode, the same laser induces a controlled layer of dermal RTD, stimul ating the dermis to achieve collagenesis and collagen remodeling and giving good long-term results.