How does an Er:YAG laser work?
Because 2940 nm is absorbed very well by water, energy concentrates in the very superficial skin layer and vaporises thin layers of tissue.
This wavelength produces a more superficial effect than a CO2 laser, with less spread of heat damage to surrounding tissue. It can be applied across the whole surface or in a fractional way, in small dots. With fractional treatment the skin heals faster from the intact areas in between.
The name Exolase is used in some centres for an Er:YAG device; manufacturer and technical specifications may vary with device version. It is therefore more meaningful to ask at consultation about the wavelength, mode and energy settings to be used than to rely on a brand name.
Which concerns might Er:YAG be considered for?
It can be discussed for superficial lines, mild acne scars, sun-related texture changes and some superficial skin lesions.
Resurfacing suits irregularities of the top skin layer. Its effect may be limited for deep wrinkles, marked sagging or deep acne scars, and other approaches may be considered. Treating spots in the same area without establishing their cause is not advised.
It can be compared with other resurfacing options such as microneedling, chemical peels or CO2 laser. Which is suitable depends on the goal, skin type and how much recovery time you can allow.
Who may not be suitable, and what are the risks?
Active infection, a history of cold sores, recent isotretinoin use, tanning, a tendency to keloids and darker skin types call for caution.
In ablative laser treatment the skin surface stays open for a while, so there is a risk of infection, cold sore flare, prolonged redness and colour change. In people with a cold sore history the doctor considers protective measures. In darker skin the risk of post-treatment darkening (hyperpigmentation) is higher. A keloid or hypertrophic scar tendency, pregnancy and breastfeeding, and recent isotretinoin use can delay treatment.
Scarring and temporary lightening or darkening can occur rarely. Strict sun protection is needed during healing. If you have unexpected pain, discharge, fever or spreading redness, contact a doctor promptly.
What does recovery look like?
Depending on depth, the skin may be red, dry and flaky for days; with fractional treatment the time is usually shorter.
In the first days there may be a burning sensation, swelling, oozing and thin crusts. Advice such as keeping the skin moist and not touching the area is given by the doctor; picking at crusts can increase the risk of scarring and pigment change. Redness can sometimes last for weeks.
This period can affect work and social plans. If there is an important event, treatment should be timed accordingly. The result becomes clear over several months.
Frequently asked questions
What is the difference between Er:YAG and CO2 laser?
Er:YAG has a more superficial effect while CO2 produces deeper heat. This affects recovery time and risks; the choice is the doctor's.
How long should I protect myself from the sun after Er:YAG?
Sun protection is needed throughout healing and for a long time afterwards. Follow the doctor's advice for duration and method.
Is anaesthesia needed during the procedure?
The area is prepared according to the treated region and depth. The method is decided by the doctor.
How long do results last?
Because ageing and sun exposure continue, duration varies between people; no duration can be promised.
Sources (4)
- U.S. FDA (510(k) Premarket Notification database): 510(k) K101916: JOULE MULTI-PLATFORM SYSTEM (2011)
- Facial Plastic Surgery: The Role of Er-yag Glass Laser in Skin Resurfacing (2022)
- American Society for Dermatologic Surgery: Laser Resurfacing
- American Society of Plastic Surgeons: Laser Skin Resurfacing Recovery
This content is for general information and does not replace a personal medical assessment.