Article medically reviewed by Dr. Gavin Chan (MBBS, cosmetic physician, liposuctionist)
Templestowe Lower and Berwick Clinics
Dr. Gavin Chan has a background in intensive care, anaesthesia, and emergency medicine. Since 2004, Dr. Chan has provided cosmetic procedures, including anti-wrinkle injections, dermal fillers, liposuction, fat transfer, skin needling, and laser treatments. He is a doctor trainer for various dermal fillers and anti-wrinkle injections.
- The erbium laser has a wavelength of 2940nm which is primarily attracted to the water in skin
- It ablates a very fine layer of the skin with each pass and this helps to resurface skin to reduce wrinkles, acne scarring, pigmentation, and for the removal of skin lesions
- The recovery time from erbium laser resurfacing is usually around 1-2 weeks
What is the erbium laser?
The erbium laser is a emits a wavelength of 2940 nanometres (nm). This laser wavelength is primarily attracted to the water in skin. This attraction to water causes controlled ablation of a very fine layer of skin. This laser can therefore be used to resurface the skin and help to reduce wrinkles, acne scarring, and pigmentation. The laser can also be used to remove various skin lesions (skin lumps and bumps).
Water is a primary constituent of the skin and the erbium laser has an extremely high affinity to the water in the skin. Therefore, as soon as the laser energy reaches the skin, it immediately vapourises the skin on contact due to its high affinity to the water in the skin. The erbium laser has a very shallow penetration depth, as once it hits the skin’s surface the energy is immediately absorbed by the skin water. There is therefore very little heat energy transmitted to the deeper layers of skin.
In comparison, the carbon dioxide laser is also attracted to the water in the skin, but not as strongly as the erbium laser. Therefore, some of its energy continues to penetrate deeper into the skin’s surface, as not all of the energy is absorbed immediately in the top layers. This deeper heating of the skin leads to tissue tightening and contraction, something that is not seen with the erbium laser. When resurfacing skin, often a combination of the two lasers are used to exploit both their properties.
What are the main uses of the erbium laser?
As the erbium laser is used to remove very fine layers of the skin, it is used primarily to resurface skin for;
- Wrinkle reduction –it is possible to resurface wrinkles by inducing new collagen and skin regeneration by ablating a very fine layer of skin with each pass of the erbium laser. The greater the number of passes, the deeper the resurfacing of the skin, the longer the recovery period, and the better the results. Recovery from laser skin resurfacing with the Erbium usually takes 1 to 2 weeks.
- Treatment of acne scarring – the erbium laser can be used in the treatment of atrophic (indented) acne scars. By ablating the superficial layers of the skin, new collagen and skin is regenerated, and the skin tends to return with a more even texture.
- Pigmentation – the erbium laser can also be used to treat pigmentation on the skin by removing the top layers of the skin where the pigmentation resides. Pigmentation treatment is not usually performed with the erbium laser unless it is done in conjunction with skin resurfacing for wrinkles. The downtime/recovery is longer than other lasers such as the medlite or ruby lasers that can remove pigment more specifically with less downtime and without having to remove layers of the skin.
- Removal of skin lesions – The erbium laser can be used to remove skin lesions that may be better suited to removal with laser rather than surgical excision. For example, various skin tags, solar keratosis, and benign naevi can be treated. It is not suitable for the removal of melanoma.
- Treatment rhinophyma – rhinophyma is a condition that leads to sebaceous gland enlargement on the nose and a bulbous nose. It is associated with a condition called rosacea. The erbium laser can help to remove these excess tissues on the nose and return it to its normal size and shape.
What is involved with erbium laser treatment?
A consultation with one of our doctors is the first step to assess if you are a suitable candidate for erbium laser treatment. Depending on the skin type, you may require preparation with certain skin care products such as topical retinoids or hydroquinone for a month or two to help flush out excessive skin melanin and even out skin thickness to reduce the incidence of possible complications such as post-inflammatory hyperpigmentation or an uneven response to the laser.
For resurfacing of the full face, usually some form of sedation is required to make the procedure a comfortable one. We usually use intravenous sedation to achieve a level of sedation where you are still able to respond to verbal stimuli, but usually have very little memory of the procedure. After sedation is administered, local anaesthetic is injected into the face to numb the skin completely. Note that for treatment of smaller areas, it is possible not to use sedation, but when treating the full face, sedation is required due to the number of local anaesthetic injections required.
Who is suitable for erbium laser treatment?
The erbium laser is suited for resurfacing skin on people who have mild to moderate wrinkles, sun damage, or acne scarring. It is best suited to fairer skin types. Those who have darker skin types are more likely to have complications from treatment (see below). It is not suited to those who are pregnant or breast-feeding, have a history of keloid scarring, and those who have had Roaccutane in the past 6 months.
What are the side effects/risks of erbium laser treatments?
The erbium laser, when used for skin resurfacing, usually takes approximately 1 to 2 weeks to recover from. The skin usually appears red, swollen, and then crusts over this period. There may be some residual redness that can persist for 1 to 2 months in some cases, depending on the severity of the treatment.
Infection with the herpes (the cold sore virus) or bacterial infection are possible after erbium laser resurfacing, and prophylatic medication for these conditions needs to be taken before and after treatment.
There is a small risk of skin pigment changes after erbium laser treatments. Especially if the patient’s skin type is olive or darker, the risk of hyperpigmentation (increased skin pigmentation) or hypopigmentation (decreased skin pigmentation) is possible. Hence, we usually restrict erbium laser treatments to those with lighter skin types.
Rarely, scarring can occur with erbium laser treatments. This occurs when the depth of the resurfacing/treatment exceeds a level where the skin is able to regenerate completely.
Why choose Victorian Cosmetic Institute as your provider of erbium laser treatment?
Having a wide range of lasers to choose from helps us to provide you with the laser treatment that is most suited to your skin and skin concerns. The erbium laser is one of the tools we use, and after a consultation with one of our doctors, we will be able to decide which laser is the best one to use on your skin.
The first step is simply contacting us for your initial laser skin rejuvenation consultation, where we will discuss with you what is a realistic and achievable outcome, and what to expect from your laser treatment.
Making that first phone call about any cosmetic procedure can be a confronting task – many of our patients have preferred filling out our online enquiry form. We can then contact you with an understanding of the results you are hopeful of achieving and ensure the treatment is appropriate.