Laser resurfacing with a long pulse Erbium : YAG laser compared to the 950ms pulsed CO2 laser

Background and Objective: Laser resurfacing with the 950 mus pulsed CO2 las er is an effective treatment for photodamage and acne scarring; however, th e potential for prolonged erythema and delayed re-epithelialization dissuad e many patients from the procedure. With the use of erbium lasers alone, th ere is a decrease in the incidence and severity of these adverse sequelae; however, it is difficult to achieve the same degree of improvement as with the CO2 laser because of the more superficial depth of resurfacing. Thus, n ew erbium lasers have been developed with longer pulse durations to deliver increased thermal effects to tissue. It is hypothesized that with the use of these lasers, diminished erythema and faster wound healing will be obser ved as well as enhanced clinical outcomes. Study Design/Materials and Methods: Sixteen patients were randomized to rec eive laser resurfacing on one-half of the face with the 950 mus pulsed CO2 laser (UPCO2) followed by short pulse erbium:YAG ablation, and to the other half with a variable pulsed erbium laser (VP Er:YAG) followed by tradition al short pulse erbium laser. Patients were evaluated clinically before resu rfacing and at 1, 2, 4, 8, and 12 weeks post-operatively. Histologic sample s taken at various time periods before and after resurfacing were also eval uated. Results: Overall clinical improvement was equal for both UPCO2 and VP Er:YA G treated sides with an average improvement in photoaging scores of 57%. De creased erythema, less edema, and faster healing were observed on the VP Er -YAG treated side. Conclusion: The VP Er:YAG laser can achieve a similar degree of improvement as seen with short pulse CO2 laser resurfacing with decreased thermal tiss ue effects and decreased risk for adverse sequelae. (C) 2001 Wiley-Liss, In c.