What it means for a patient
- CO2 laser resurfacing gave somewhat more wrinkle improvement, but with more redness and more skin lightening.
- Erbium laser healing was quicker, and with more passes its results approached CO2.
- Skin lightening after CO2 occurred in 43% of treated sides in this study. Ask about this risk.
- The study had 21 subjects with lighter skin types only; results may differ in darker skin.
Why this paper matters
It compared the two main resurfacing lasers on the same faces and measured the trade-off between wrinkle improvement and side effects. The authors conclude erbium:YAG is safe and effective with faster recovery than CO2.
Overview
The authors compared two resurfacing lasers for facial wrinkles. 21 volunteers with skin types I to III each had one side of the face treated with a CO2 laser and the other with an erbium:YAG laser, and were followed for 6 months. Results were rated by subjects, investigators and a blinded expert panel, and 6 subjects had skin biopsies.
Findings
- 21 subjects (19 women, 2 men); skin type I to III; wrinkle class I to III; academic referral center; 6-month follow-up.
- Split-face design: CO2 on one side, Er:YAG on the other.
- Wrinkle improvement was relatively better on the CO2 side across all subjects (P < .03).
- With more than 5 passes of Er:YAG, improvement was not significantly different from 2 to 3 passes of CO2.
- Redness at 2 weeks: 14 subjects (67%) on the Er:YAG side, 20 subjects (95%) on the CO2 side.
- Redness was significantly less frequent after Er:YAG at 2 weeks (P = .001) and 8 weeks (P = .03).
- Hypopigmentation: 1 Er:YAG side (5%) vs 9 CO2 sides (43%) (P < .05).
- Residual heat damage on biopsy: up to 50 µm with Er:YAG, up to 200 µm with CO2.
Terms
- Erbium:YAG laser: a resurfacing laser that removes skin with less heat spread than CO2.
- CO2 laser: a resurfacing laser that removes skin and heats the tissue below.
- Rhytides: wrinkles.
- Split-face study: a study where each side of the same face gets a different treatment.
- Erythema: redness of the skin.
- Hypopigmentation: lightening of the skin.
- Residual thermal damage: the depth of heat injury left in the skin after laser treatment.