Comparison of Erbium:YAG and Carbon Dioxide Lasers in Resurfacing of Facial Rhytides

Ablative fractional lasers (CO2 and Er:YAG): A randomized controlled double‐blind split‐face trial of the treatment of peri‐orbital rhytides

“…In contrast to some claims in the literature [19], the present study failed to demonstrate appreciable differences between both methods in treating peri-orbital rhytides in a meticulously chosen experimental setting with randomized, blind allocation of treatment sites in a split-face design. Correspondingly, this confirms previous comparative reports about non-fractional skin resurfacing [4][5][6][7]. Basically, the efficacy of both methods was roughly equal, and whereas the discomfort was somewhat more pronounced after Er:YAG treatment during the first days (with the notable exception of bleeding), CO 2 treatment was perceived as more unpleasant in the later course of follow-up.…”

“…In contrast to CO 2 lasers (10,600 nm), the Er:YAG laser has a technical benefit because its wavelength of 2,940 nm is much closer to an absorption maximum of water (3,000 nm) [3][4][5], thus allowing for high precision yet superficial skin ablation. With the selection of appropriate parameters, however, the biophysics of CO 2 and Er:YAG laser -tissue interaction creates similar injuries and cosmetic results [4][5][6][7]. Conceivably, the shortcomings of both methods are very similar: while they produce clinically efficacious results, the intensity and depth of the thermal injury may require anesthesia and result in unwanted effects such as hypo-or hyperpigmentation, prolonged wound healing and even scarring [1,6,8,9].…”

“…With the selection of appropriate parameters, however, the biophysics of CO 2 and Er:YAG laser -tissue interaction creates similar injuries and cosmetic results [4][5][6][7]. Conceivably, the shortcomings of both methods are very similar: while they produce clinically efficacious results, the intensity and depth of the thermal injury may require anesthesia and result in unwanted effects such as hypo-or hyperpigmentation, prolonged wound healing and even scarring [1,6,8,9]. Extended downtime and long lasting side effects are obvious drawbacks for patients undergoing these procedures.…”

“…Whereas several studies claim encouraging results of erbium lasers (e.g., [12][13][14]), the same holds true for fractional CO 2 ablation [15][16][17]. There is very little evidence on the comparative safety and efficacy of both methods, but the limited scope of the literature to date suggests a roughly equivalent status [18], just as it does for non-fractional applications [4][5][6][7]. However, claims that the fractional CO 2 laser is superior to fractional Er:YAG [19] call for evidence-based scrutiny, as do the extremely encouraging results of fractional erbium lasers [14,20].…”

Er:YAG laser skin resurfacing using repetitive long‐pulse exposure and cryogen spray cooling: I. Histological study*

“…This procedure rejuvenates the skin and signi®cantly improves rhytides in properly selected patients. It has been noted, however, that rhytid improvement achieved after Er:YAG LSR is, in general, less pronounced compared with wounding to equivalent depth with the CO 2 laser [6]. This can be attributed to the difference in injury induced by the two lasers.…”