Er:YAG Lasers

What is an Er:YAG Laser?

Erbyium-doped YAG Lasing Crystal Used in Er:YAG Lasers

Along with carbon dioxide lasers, Er:YAG lasers are the system of choice for ablative laser skin resurfacing. Er:YAG utilize erbium-doped yttrium aluminium garnet as the lasing medium and produce a laser of 2940 nm. This wavelength is in the infra-red spectrum and is strongly absorbed by water. It is commonly used to treat skin damage, including acne scars and melasma (excess pigmentation). Er:YAG lasers are also routinely used to cut bone and tissue. They are used in laser dentistry and other surgical applications.

How does Er:YAG Treatment Work?

Er:YAG lasers work by ablating (vaporizing) the surface layer of the skin. Each pass with the Er:YAG laser removes approximately 10 micrometers of skin tissue, about 1/100th of a millimeter. This type of technology is the basis for the procedure known as a “laser peel”. Er:YAG lasers primarily target the surface of the skin, and are not as effective as CO2 lasers at remodeling the collagen matrix underneath the skin. As a result, Er:YAG lasers are excellent options for repairing minor to moderate scarring and other skin damage, but are less effective for severe scarring, particularly pitted scars. Because Er:YAG lasers target the surface of the skin, the recovery times are faster and the side effects are generally milder than more invasive laser resurfacing techniques.

Are Er:YAG Easers Effective treatment for Acne or Acne Scars?

Er:YAG Lasers are Used Extensively for Superficial Skin Resurfacing (Ko)

While Er:YAG lasers could conceivably be used for treatment of acne vulgaris, they are usually used to treat scarring, after the active acne infection has been resolved. Er:YAG lasers have a good efficacy profile against mild to moderate acne scarring. They are generally considered to be more effective for these purposes than most other light and laser treatment modalities, such as Nd:YAG, pulsed dye lasers (PDL) and intense pulsed light (IPL). Because Er:YAG lasers effectively and efficiently target the surface of the skin, there is usually less collateral thermal damage and faster recovery periods than more invasive laser resurfacing systems, like CO2 lasers. Their limited side effect profile, combined with decent efficacy and generally positive patient response has made Er:YAG lasers a popular treatment option. The biggest limitation of Er:YAg lasers is their inability to effectively treat the extensive and deep scarring that is common in those who have suffered from severe inflammatory and cystic acne. For moderate to severe cases, the more invasive C02 lasers generally provide better improvement, although their side effects are more severe and recovery periods can be significantly longer.

How and Where is Er:YAG Laser Treatment Administered?

Er:YAG treatment is administered in cosmetic surgery clinics, dermatology offices and hospitals.

How Much does Er:YAG laser Treatment Cost?

The Fraxel Re:Store Fractional Er:YAG Laser is a Popular System
The cost of Er:YAG treatment varies greatly depending on the area being treated, the number of passes (how many times they go over a particular area during a single treatment), the number of treatment sessions, and the general costs of laser surgery in your market. Generally speaking, the cost ranges from $200 to $700 dollars per treatment session for treatment of facial acne scars. In many cases, multiple treatments are necessary to achieve significant results. A complete Er:YAG treatment plan for facial acne scars often costs in excess of $2000.

Popular ER:YAG Systems
FRAXEL RE:STORE (fractional Er:YAG laser system)
Sciton Profractional and Contour TRL

Before and After Er:YAG Laser Treatment Pictures of Acne Patients

A collection of before and after photos of Er:YAG patients can be found here.

Related Posts @ The Science of Acne

Before and After Pics: Er:Yag Laser Treatment
Overview: Light and Laser Acne Treatments
Overview: Acne Scar Treatment
In Depth: What Causes Acne?

References and Sources

Research Articles

Resurfacing of Pitted Acne Facial Scars with a Long Pulsed Er:YAG Laser.
Jeong, et al. 2001.  For article abstract, click here.
Resurfacing of Pitted Facial Acne Scars Using Er:YAG Laser with Ablation and Coagulation Mode.
Jeong, et al. 2003.  For article abstract, click here.
Treatment of Atrophic Acne Scars with a Dual Mode Er:YAG Laser.
Tanzi, et al. 2002.  For article abstract, click here.
Minimally Ablative Erbium:YAG Laser Resurfacing of Facial Atrophic Acne Scars in Asian Skin: A Pilot Study.
Tay, et al. 2008.  For article abstract, click here.

Online Resources and Links

Cutaneous Laser Resurfacing, Erbium-YAG @ Emedicine
Er:YAG laser @ Wikipedia
Er:YAG Patient Message Board @