Skin Rejuvenation on Skin Types I to V Using a 300-microsecond Pulsed Er:YAG 2940nm Laser in Sub Ablative Mode

James Gordon, MD, Ophthalmology, White Plains, NY | Khalil Khatri, MD, Dermatology, Cambridge, MA | Viktor Moiseev, MD, Dermatology, Ryazan, Russia

Laser resurfacing has been a popular procedure to reverse the effects of aging. CO2 and Erbium:YAG lasers are highly effective in treatment of wrinkles and acne scars. These ablative lasers have long down-time and limit patient’s activities. These lasers can results in significant pigmentary changes and if not used with a proper technique by well trained laser surgeons, it can result in disfiguring scarring. Due to these limitations, almost all available lasers were tried to use for non-ablative resurfacing. These reduced the down-time and risk of complications but effectiveness was not comparable. Fractional lasers were introduced to get same kind of results. Non-ablative fractional laser did not produce same effectiveness as ablative CO2 or Er:YAG lasers. This lead to the development of Ablative fractional lasers. Ablative lasers have been used at low fluence, but in ablative mode to treat mild photoaging and acne scars. This study is to evaluate the use of an Erbium:YAG laser in a “sub-ablative” mode where there is a heating of the surface tissue with no ablation.

In this multi-center study 35 subjects were treated with 3 passes in a sub-ablative mode. The treatments were repeated 2-4 times. No topical anesthesia or skin cooling was required.

Subjects tolerated the procedure well. Subjects experienced slight peeling of facial skin, if any, for 2-4 days after the treatment. There was improvement in skin texture, pore size, pigmentation, etc. There were no complications, except one subject developing transitory mild hyperpigmentation. This study shows that Er:YAG laser in a sub-ablative mode is safe, gentle and effective for facial skin rejuvenation.