Scars and scars Laser removal 6 clinics in Moscow since 1994

Anyone can be interested in scar camouflage. It is not necessary to have a profession that involves constant risk, or to be a fan of extreme sports. The causes of scars vary from accidental falls in childhood to serious injuries. People with thin skin know that even minor scratches leave marks.

If scars are almost inevitable, then what remains: to come to terms with them and have a complex, being embarrassed to show your body and choosing special clothes, or to find an effective way to say goodbye forever to the scars that cause you discomfort? In modern conditions, you can absolutely choose the second option - and enjoy your body.

At the same time, you don’t have to spend fabulous amounts of money and a lot of time to eliminate skin defects that bother you. What are the ways to deal with scars and how to choose the one that suits you? We will talk about the two most popular methods of getting rid of the consequences of violation of the integrity of the skin. Today, clients choose between laser resurfacing and scar camouflage based on the features of these procedures.

The principle of laser scar removal method

Laser scar removal (reviews about the procedure are mostly positive) is carried out after examining the patient.

Laser scar removal is an effective modern cosmetic procedure for smoothing out skin imperfections from injuries, stretch marks, acne, and cuts.

During the inspection, the specialist identifies the type of damage:

• Scars of atrophic type. The defect looks like a depression in the skin caused by weight loss, burns, or chicken pox. Most often they are found in the areas of the hips, chest, abdomen and legs.
• Stretch marks. The defect is formed due to rapid stretching of the skin. They can form during weight loss or pregnancy.
• Keloid type scars. The most difficult case. Dark burgundy bumps on the skin are visible to the naked eye. Scars form after surgery due to the synthesis of excess collagen at the incision sites.
• Scars of hypertrophic type. Purple scars are formed from connective fibrous tissue. Occurs with deep wounds.
• Scars of normotrophic type. The mildest skin defect. The scars are pale pink in color. They occur after abrasions, scratches and cuts have healed.

Depending on the type of damage, the type of laser that will be used in the skin resurfacing process is determined.

The specialist also clarifies a number of parameters:

• the area of ​​skin that needs to be treated;
• depth and intensity of impact;
• laser wavelength and spectrum;
• duration of the procedure.

Skin defects are eliminated with an erbium or neodymium laser.

What is a scar? What types of scars are there?

The following types of scars are distinguished:

Advantages and disadvantages

Cosmetic laser skin resurfacing has a number of advantages. The patient does not need to be observed in a hospital: after the procedure, he is sent home 2-3 hours later. Scars can be removed with laser anywhere (including the bikini area). A positive result is noticeable after a short time. The leather does not need to be pre-treated.

The laser has no effect on healthy skin tissue. During the procedure, not only stretch marks and normotrophic scars are reduced, but also keloid scars. The technique is considered universal: it is used in practice regardless of the patient’s ethnicity.

Disadvantages include the presence of absolute contraindications to resurfacing and the high cost of the procedure.

Contraindications

Laser scar removal (reviews prove the effectiveness of the technique) has a number of contraindications.

The following are considered absolute restrictions:

• the presence of diseases of the central nervous system or mental disorders;
• long-term use of drugs that can slow down the coagulation process;
• diseases of infectious etiology;
• individual characteristics of the body. in which keloid scars rapidly form;
• skin damage, including eczema and dermatitis;
• diabetes mellitus (regardless of type);
• the period of bearing a child and feeding him breast milk;
• growth of benign and malignant neoplasms.

It is strictly forbidden for people under the influence of drugs or alcohol to undergo laser facial resurfacing. During the hot season, it is recommended to refrain from cosmetic procedures. In summer, the body produces melanin in large quantities, so pigment spots may appear on the face after exposure.

Types of laser removal of facial scars

Laser scar removal (reviews will help you verify the effectiveness of the method) is carried out in several ways (depending on the type of exposure). The specialist selects the type of laser suitable for a particular patient during a visual examination. If the skin is sensitive enough, the procedure is carried out under local anesthesia.

The scar layer is removed in 25-35 minutes. During laser resurfacing, excess fluid from the cells evaporates, so after manipulation it is necessary to restore the water balance. Scars are removed with an erbium or neodymium laser.

Erbium

Under the influence of a laser wave, the skin is heated. The grinding procedure ensures cleansing of dead cells and starts the regeneration process. The laser is a large instrument containing erbitol mixed with quartz. The device is equipped with a transmitter and laser beam amplifier.

During exposure, blood circulation in the skin is normalized, which minimizes the risk of swelling and edema. In addition to smoothing scars, the laser restores the process of collagen synthesis. This allows you to reduce the number of facial wrinkles. During the procedure, the skin is cleared of pigment spots.

Neodymium

When exposed to a neodymium laser, not only the scars are smoothed out, but also the elasticity of the skin is restored. Non-ablative rejuvenation is based on stimulation of collagen production processes. The neodymium laser quickly and painlessly removes arterial and venous networks.

People with sensitive skin may experience slight discomfort during resurfacing. The beam penetrates into the deep layers of the skin, so the procedure can be performed under local anesthesia.

Laser skin resurfacing: what is it?

Dermabrasion is a peeling procedure of the epidermis, as a result of which the dermis is partially removed. To implement the method, a laser is used, which activates collagen production. The penetration depth of the laser beam is 150 microns, which allows it to reach the basement membrane. As a result, the relief of the scar is smoothed out, leveling it out.

Types of grinding

Depending on which laser is used, there are several types of dermabrasion.

1. Laser resurfacing is effective in getting rid of scars that form due to improper fusion of wound edges, injuries, and a tendency to develop keloid scars. In fact, the beam penetrates the connective tissue and completely destroys it, stimulating the active development and division of neighboring epidermal cells.
2. Fractional resurfacing is carried out with an erbium or carbon dioxide laser. The latter is more gentle on the skin. If handled carelessly, the epidermis becomes very hot, which can lead to burns.
3. Carbon dioxide laser is not comparable to scar camouflage, because, although it guarantees the most noticeable result, it can also lead to complications. And the rehabilitation period is particularly long and complex.
4. Traditional laser resurfacing involves the beam penetrating deep into and destroying the affected layers of skin. The high efficiency of the method is accompanied by a long recovery period.
5. Erbium laser provides a good lifting effect. The beam affects the affected areas of the epidermis, over which new cells are “pulled together.” Variable laser power allows you to change the depth of action of the beam.

Features of the procedure

Suitable for people of any age. It is necessary to ensure that there are no allergic reactions or skin diseases. To make the process more effective, it is recommended to pre-chemically peel the upper layers of the skin. The effectiveness also depends on the phototype. The darker the skin, the higher the likelihood of pigmentation developing. Bleaching is carried out in order to avoid possible negative consequences.

How is laser resurfacing performed?

When choosing between scar camouflage and laser resurfacing, it is necessary to take into account the specifics of its implementation. Preliminary preparation consists of applying an external anesthetic (gel, spray). If the case is complex, it may even be possible to use general anesthesia. After the laser works, the skin becomes light white, this indicates that the beam has penetrated the basement membrane. Next, the anesthetic is applied again and the laser is repeated until the affected layers are completely removed. The duration of the procedure depends on the area of ​​the affected area, the condition of the skin, its type and other individual characteristics of the patient.

Skin care after resurfacing

For several days after laser exposure, it is forbidden to touch the skin with your hands or apply cosmetics. At first, the area is covered with a sterile bandage. After a week, crusts form that cannot be torn off on your own. This is a natural process, after which the epidermis becomes covered with red spots, which completely disappear within 3-6 months. Depending on the type of sanding and the size of the area being treated, recovery can take from a couple of weeks to several months.

Preparation

Laser removal of scars and scars requires certain preparation. According to reviews, it is necessary to adhere to a diet for several days before and after the procedure. It is necessary to completely remove from the diet foods that can provoke an allergic reaction. Experts also recommend avoiding spicy, salty and smoked foods that cause thirst.

Before laser scar removal, you should not eat fried, smoked or salted foods.

Before the session, the patient must consult with a doctor: the specialist will explain the principle of the procedure, the stages of its implementation, possible contraindications and complications.

To achieve optimal results, you need to properly prepare for sanding:

• 2 weeks before the session, stop taking hormonal drugs, antibiotics, photosensitizing drugs and retinoids;
• stop taking painkillers, anticoagulants, analgesics and antispasmodics 48 hours before;
• 2 weeks before the session, procedures during which the skin is exposed to ultraviolet radiation are completely abandoned.

The patient is required to donate blood for hepatitis and HIV in advance.

How does laser work in scar treatment?

Laser scar treatment is the only procedure that can reduce the depth of scars and eliminate them permanently.

The essence of laser scar treatment is to remove the top layers of skin along with scar tissue. At the same time, restoration processes in the treated areas are enhanced, new young collagen and elastin are synthesized, which leads to the formation of a normal structure of the dermis.

It should be noted that red fresh scars and keloid scars are not always indications for scar resurfacing. As a rule, you should wait until the inflammation subsides and the formation of scar tissue stops before performing the laser scar removal procedure. On average, this process takes up to six months.

Stages of the procedure

It is impossible to say exactly how long laser scar resurfacing will last.

This indicator is purely individual and can be influenced by a number of factors:

• area of ​​skin lesion;
• type of laser used in the process.

In most cases, the session lasts 20-60 minutes.

Before laser resurfacing, the patient signs documents, thereby confirming that he is familiar with the basic principles of laser resurfacing, warned about the possible consequences and agrees with its cost.

The laser cleaning procedure takes place in several stages:

1. The patient lies down on the couch. An anesthetic solution is applied to him after preliminary cleansing of the skin.
2. Using the program, the specialist selects the depth of exposure of the laser beam and the duration of the session.
3. The anesthesia begins to take effect within 20-30 minutes. Mild discomfort (tingling, burning) is considered normal. Severe pain may indicate poor quality anesthesia.
4. After smoothing the scars, apply a nourishing cream or any other hypoallergenic product to the skin to help restore water balance.

The patient can leave the cosmetologist’s office after 30-60 minutes. after laser resurfacing.

Post-acne correction techniques

Before the era of laser technology, there was no effective and safe treatment for acne scars. In order to correct them, deep peelings were used, which often resulted in burns, continuous scarring of the treated area and a questionable aesthetic result 2, 3.

Currently, the most effective, fast and safe method of treating atrophic post-acne scars is the use of DOT and DROT therapy using the SmartXide2 from DEKA (Italy).

The advantages of this technique include not only the combination of a CO2 laser with RF radiation, but also the ability to modulate the pulse shape and the presence of five levels of stacks (patented technology from DEKA).

The effectiveness of treatment of scar tissue with the SmartXide2 laser device consists of the following factors:

• Point fractional vaporization of microscopic areas of the skin occurs at a strictly specified depth, which leads to a reduction in the area of ​​the treated area, the formation of tissue heating zones (in undamaged areas of the skin) and, as a result, active stimulation of new collagen.
• When using DROT therapy, the initial effect on the tissue is made by a CO2 laser pulse, preparing the skin for subsequent exposure to RF radiation by increasing blood flow in the dermis, as a result of which its conductivity for thermal energy significantly increases. Subsequent RF radiation, penetrating deeply into the dermis, can provide intense and long-term stimulation of fibroblasts without damaging the skin. It is noted that even when choosing higher parameters of laser energy when using combined (DROT) therapy, an increase in the recovery period is not typical.
• For laser therapy of post-acne scars, the depth of penetration of the laser beam and the ability to flexibly change this parameter are fundamentally important. SmartXide2 allows, due to the stacking mode from 1 to 5 levels, to adjust the depth of exposure without pronounced lateral thermal damage, making it possible to carry out highly effective and differentiated laser therapy for scars with minimal risk of side effects, even when using high laser energy parameters.
• An undeniable advantage in working with scars is the ability to modulate the pulse shape. In particular, when working with deep atrophic scars and thick porous skin, the D-Pulse pulse shape is preferred. This form of pulse has a high peak power, which does not depend on the subsequent thermal part, which makes it possible to achieve pronounced tissue shrinkage and leveling of its relief.

It must be especially emphasized that the basis for the effectiveness of this laser is a combination of parameters: modulation of the pulse shape, adjustable depth of impact (stacks) and adjustable distance between points, which provides doctors with effective opportunities to control the nature of the impact, individualize therapy and avoid the occurrence of excessive thermal damage to the lateral zones, which directly reduces the risk of post-inflammatory hyperpigmentation. This is especially relevant when treating scars in patients with skin phototype III and higher.

In addition to the general standard contraindications for laser therapy, special attention should be paid to patients receiving oral retinoid treatment for the treatment of acne. When taking them, thinning of the skin, the occurrence of hypersensitivity (including to solar radiation), impaired cell differentiation, and slower repair may be observed. Therefore, in this category of patients, laser therapy for post-acne scars is contraindicated for use during the entire period of drug therapy and 6 months after it in order to prevent the occurrence of dyschromia and pathological scarring.

How many sessions will it take to completely get rid of facial scars?

It is almost impossible to get rid of scars in one session. The number of procedures directly depends on the location, severity and size of the scars.

Approximate timing (depending on the type of defect):

• Normotrophic scars are completely smoothed out in 2-3 sessions.
• Atrophic scars are deeper, so their elimination will require up to 4 sessions.
• Hypertrophic scars are considered defects of moderate severity. To smooth out damaged skin, up to 5-6 sessions are necessary.
• Keloid scars are eliminated in several stages. In addition to laser therapy, the patient should use medications that help smooth the skin. Over several procedures, a reduction in the scar by 5-60% is observed (compared to the original size).

A full course of laser therapy includes up to 10 sessions. They are carried out regularly, maintaining an interval of 2-4 weeks.

How many treatments are needed to remove scars?

The number of procedures depends on the age, type and size of the scar. Normotrophic scars are most favorable for correction. Atrophic scars (for example, post-acne scars) can completely disappear either after one procedure or after a series of laser resurfacing, which is determined by the depth of the scars. Correction of large hypertrophic scars is complex and requires multiple resurfacings. The most difficult to correct are keloid scars; the question of the advisability of their resurfacing is decided individually, and, as a rule, is accompanied by drug therapy. After the first resurfacing, the scar is usually reduced by 20-30%.

Photos before and after, results

The result is noticeable after 2-3 sessions. To achieve the desired effect, experts recommend taking a full course of laser resurfacing, during which the scars will resolve. Renewed and healthy skin appears at the site of defects.

Further skin care

The recovery period after laser resurfacing is several weeks. To reduce this period, you must adhere to all medical prescriptions. It is strictly forbidden to allow dust, contaminants, or substances that can cause irritation to come into contact with the skin.

If itching occurs, it is necessary to treat the affected area with an antiseptic and apply antipruritic ointments to it.

Within 5-10 days after laser resurfacing, the patient is prescribed antibacterial drugs to minimize the risk of skin infection. To reduce swelling and reduce the severity of pain attacks, take non-hormonal anti-inflammatory drugs and analgesics.

The air in the room where the patient spends most of his time should be humid. The skin must be protected from ultraviolet rays, so experts recommend wearing masks when going outside. The skin is regularly treated with gentle antiseptics that cannot cause a burn. You cannot visit saunas and steam baths for 30 days after laser resurfacing.

During this period, creams and lotions that contain alcohol are not applied to the skin. It is strictly prohibited to treat the cover with a solution of brilliant green or iodine. During healing, crusts form that cannot be removed independently. After polishing, the skin needs to be moisturized, so natural olive or sesame oils are applied to it.

When crusts form, ichor is released from the wounds. They are treated with a solution of 6% vinegar (1 tbsp per 200 ml of boiled cool water). Moisten a napkin in the resulting liquid and apply it to the affected area of ​​the skin.

Possible complications

Complications arise when the cosmetologist fails to comply with the rules of asepsis and antisepsis or when the rules for skin care are neglected during the recovery period after laser resurfacing.

These include:

• An inflammatory reaction that lasts more than 72 hours. Complications are triggered by the individual characteristics of the skin.
• Infection. Occurs due to non-compliance with antiseptic rules before or during the procedure.
• Herpetic infection. Complications can be caused by herpes viruses, especially if the patient did not take appropriate medications 2 weeks before laser resurfacing.

If the patient has dilated capillaries, then the risk of persistent erythema is quite high. The condition persists for a long period of time (up to 8-12 months). It goes away on its own. To maintain vascular tone, you need to regularly take dietary supplements with omega-3 fatty acids.

Post-inflammatory hyperpigmentation is diagnosed in people with dark skin. The complication occurs against the background of increased melanin production. This category of patients is offered to take medications (retinoids, ascorbic and azelaic acid) that can reduce the activity of tyrosinase.

After removing scars on oily skin, seborrhea or acne may develop. This is triggered by inflammatory processes occurring inside the deep layers of the skin. The complication does not need to be treated; it goes away on its own after 45-60 days.

In people with thick skin, demarcation lines are formed after laser resurfacing. The boundaries between the affected area and the healthy area of ​​the skin are clearly visible. The line is predominantly red. To smooth it out, dermabrasion or chemical peeling is performed.

Depigmentation is extremely rare.

Clinical case

Patient, 30 years old. Since the beginning of puberty, she suffered from moderate acne, which resulted in the formation of multiple post-acne scars in the forehead, cheeks, and chin. She underwent successful treatment with retinoids (3 years ago). At the moment, I am worried about isolated periodic inflammatory rashes and cicatricial changes in the facial skin. Objectively: complex facial skin, prone to oiliness, phototype II according to the Fitzpatrick classification; multiple atrophic post-acne scars ranging in size from 1 to 5 mm in diameter are noted in the forehead, cheeks, and chin.

Procedure protocol

Preparatory stage

Signing voluntary informed consent for the laser therapy procedure, photography (portrait and macro photography).

Preparing for the procedure. Washing the skin with a mild cleanser, triple treatment with chlorhexidine, applying topical anesthesia (application time from 20 to 40 minutes depending on the patient’s pain threshold).

Procedure

It was carried out in 2 stages:

• 1st stage. Uniform processing without pulse overlap in D-pulse mode. Laser radiation parameters: energy 12W, exposure time 700 µs, distance between points 600 µm, 2 stacks.
• 2nd stage. Additional treatment of the deepest scars in D-pulse mode. Laser radiation parameters: energy 14W, exposure time 600 µs, distance between points 550 µm, 3 stacks.

Post-procedural period

Immediately after the procedure and during the early rehabilitation period (days 1–7), apply a moisturizing anti-inflammatory cream with a high concentration of panthenol and components of the lipid barrier of the skin, wash with a mild cleanser (pH 5.5), use sunscreen with SPF of at least 30.

The patient tolerated the procedure comfortably. Moderate swelling of the facial skin was observed immediately after the procedure and was completely reduced by the end of the second day. Mild erythema was observed for three days.

Further treatment tactics

Repeat the procedure after 1 month. Course from 2 to 5 procedures.

Additional recommendations

If the patient has dense, porous skin, deep and/or wide post-acne scars, the use of DROT therapy is recommended. RF energy parameters: 20-30W, exposure time 3 s. CO2 laser parameters: energy 10–20W, exposure time 500–800 μs, distance between points 550–650 μm, 2–3 stacks.

Correction result

Evening out the relief and color of the skin, improving its elastic properties and stimulating collagen synthesis, reducing the area and severity of scars.

Price of the procedure

The cost varies depending on a number of factors. The price may be affected by the size and type of defect, the type of laser resurfacing and the location of the clinic. In Moscow and St. Petersburg, the cost of a session is higher compared to other cities.

Approximate prices:

Whether a cosmetologist has certificates confirming their qualifications may affect the cost of the procedure. There is no need to pay for consumables (antiseptic solutions, moisturizing serums) separately.

Laser removal of scars, scars and stretch marks can cost the patient 10,000-15,000 rubles. According to reviews, the procedure is quite effective and painless. Complications rarely occur if skin care rules are fully followed.

Which is better – CO₂ or Er:YAG lasers? Practical advice from a cosmetologist

With increasing intensity of exposure, the heating temperature of the tissue increases, accompanied by the following processes:

• Stimulation of intracellular processes (37.5 – 39 °C)
• Protein denaturation and membrane destruction (at 40 – 45 °C)
• Coagulation and necrosis (60 °C)
• Dehydration (100 °C)
• Carbonation (150 °C)
• Vaporization (over 300 °C)

It is also worth emphasizing that the various thermal effects of laser radiation on tissue are never observed separately and are always present, however, the size of these zones depends on the wavelength of the laser system.

CO2 laser systems have a wavelength of 10,600 nm, while erbium laser systems have a wavelength of 2940 nm, while the energy absorption coefficient of the chromophore (water molecule) for this laser system is 12,000 cm-1, for a CO2 laser - 800 cm-1 . This suggests that the wavelength emitted by the erbium laser is absorbed 12 to 15 times higher than that of CO2. This leads to a difference in the thermal effect, namely in the size of the coagulation zone.

Rice. 3. The coagulation zone on a CO2 laser is 100-160 microns (depending on the set parameters), the coagulation width on an erbium laser does not exceed 30 microns

A small zone of Er:YAG tissue coagulation allows minimizing the rehabilitation period with a good clinical effect.

In foreign studies 1998–2010. comparisons of the two laser systems were carried out on large groups of subjects. For example, in one study, patients aged 18 to 88 years with perioral and periorbital scars and involutive skin changes were selected. One half of the face was treated with a CO2 laser, the other with Er:YAG. The treatment method is continuous ablation. The effect was assessed 1 day, 7 days, 6 months after the procedure.

Rice. 7. Skin biopsy (continuous laser resurfacing method): Left – Er:YAG, right – CO2

Rice. 8. Periorbital wrinkles. The left half of the face is Er:YAG, the right half of the face is CO2. Right photo – result 6 months after the procedure

Rice. 9. Oral wrinkles. The left half of the face is Er:YAG, the right half of the face is CO2. Right photo – result 6 months after the procedure

In a group of patients with involuting wrinkles of the periorbital and oral zones (age 65–80 years), positive dynamics were noted on both halves of the face, however, the lifting effect of deep skin wrinkles was better expressed on the side treated with a CO2 laser system.

Carbon dioxide (CO2) laser systems certainly make it possible to cope with a wide range of problems, especially when it comes to pronounced hypertrophic and post-acne scars of the skin due to a more pronounced thermal effect, which causes contracture of the protein due to a pronounced coagulation zone → expansion of the blood vessels of the dermis → release of pro-inflammatory cytokines → the beginning of fibrin retraction and polymerization → the start of neocollagenesis.

But what to do when it comes to atrophic skin scars?

After all, atrophic scars arise as a result of a reduced response of connective tissue to injury, as a result of which insufficient collagen is formed. The study by Tay and Kwok (2008) involved 150 volunteers with three types of atrophic scars: V-shaped, M-shaped, U-shaped, and compared the effectiveness of CO2 and erbium resurfacing when working with them. Patients who underwent erbium laser resurfacing showed improvement in U-shaped scars in 52.9% of cases, M-shaped scars in 43.1% of cases, V-shaped scars in 25.9% of cases, while As with the CO2 laser, there was a 23.3% improvement in U-shaped, 15% improved in M-shaped, 17.7% improved in V-shaped, and the erbium laser is now the standard in the treatment of atrophic skin scars.

Erbium lasers have now become the standard in the treatment of atrophic skin scars! In my medical practice, I use two laser systems:

• Eraser C-RF (CO2 laser, 10,600 nm)
• Lotus II (Er:YAG laser, 2940 nm)

The Eraser C-RF CO2 laser system has a wide range of parameters, which allows you to create individual protocols for each patient. Possibility of additional connection of gynecological and ENT instruments, without “upgrading” the device and without switching scanners. The Coherent tube (metal, double welded and vacuum) makes the laser system indefinite. A unique ability to work in stack mode (up to 50 stacks), forming an ordered factional zone in the “rain” mode by chaotic feeding in a stable mode. This function allows you to gently treat the area without the use of topical anesthesia.

Video of the CO2 laser resurfacing procedure using the Eraser-C-RF device

The modern erbium laser system Lotus II (LaserOptek, South Korea) allows for both “cold and ultra-cold” and “hot” laser grinding, close to CO2 laser systems. All this is possible thanks to the choice of pulse duration from ultra-short - 40 μs ("cold" grinding), with virtually no period of desocialization and rehabilitation ("weekend grinding"), to an ultra-long pulse with a duration of 5000 μs ("hot grinding"). Moreover, in addition to the registration certificate of Roszdravnadzor, the Lotus II device has FDA approval, which proves its widespread use in the US and European markets. The device has a number of advantages:

• Lens thermal compensator
• Flat beam profile
• Lamp life 10 million pulses
• The presence of several attachments for removing tumors, fractional resurfacing, a set of gynecological attachments

Video of the scar treatment procedure using the Lotus II laser system

Clinical cases

Rice. 10. Rejuvenation and elimination of post-acne scars using the CO2 Eraser C-RF device

Rice. 11. Elimination of stretch marks and atrophic scars using the Lotus II Er:YAG device

Conclusion

Due to the difference in wavelengths between the CO2 laser (10,600 nm) and Er:YAG (2,940 nm), the degree of absorption of laser energy by the water chromophore also differs. The energy emitted by an erbium laser is absorbed by the water chromophore 12-15 times more than that of a CO2 laser system, due to which we see completely different clinical effects. The CO2 laser copes with pronounced hypertrophic scars, deep involutional wrinkles, but almost always has a long period of desocialization and rehabilitation for the patient, while the erbium laser copes well with normal and atrophic skin scars, “face lifting”, age-related skin changes with short rehabilitation period.

In my practice, I use both laser systems (Eraser-C-RF and Lotus II), since they do not exclude, but complement each other and open up wide opportunities for solving many aesthetic problems!

Sources

1. Khatri KA, Ross V, Grevelink JM, Magro CM, Anderson RR. Comparison of Erbium:YAG and Carbon Dioxide Lasers in Resurfacing of Facial Rhytides. Arch Dermatol. 1999;135(4):391–397. doi:10.1001/archderm.135.4.391
2. Goldust M (2014) The efficacy and safety of Er:YAG laser for the treatment of atrophic acne scars, 1: DOI: 10.15761/GOD.1000116
3. Tay YK, Kwok C (2008) Minimally ablative erbium:YAG laser resurfacing of facial atrophic acne scars in Asian skin: a pilot study. Dermatol Surg 34:681–685
4. Hu S, Hsiao WC, Chen MC, Huang YL, Chang SL, et al. (2011) Ablative fractional erbium-doped yttrium aluminum garnet laser with coagulation mode for the treatment of atrophic acne scars in Asian skin. Dermatol Surg 37:939–944.

Author

Karmanchikov Vladimir Sergeevich - dermatovenerologist, cosmetologist, trichologist, laser therapist. Certified Clinical Trainer.