Erbium Yag Laser Skin Resurfacing - Indication, Contraindications, Advantages, and Complications

Introduction:

Laser skin treatments are in much demand due to lesser recovery time and better results. Erbium Yag laser skin resurfacing is a substitute for chemical peel treatment as it works in the top layer of the dermis (papillary dermis) to rejuvenate the skin and boost collagen production. This treatment can treat symptoms like acne spots, scars, wrinkles, and skin pigmentation.

What Is Erbium Yag Laser Skin Resurfacing?

Erbium Yag Laser (Erbium-yttrium-aluminum-garnet) laser resurfacing is a procedure in which skin is rejuvenated by removing its outer surface with the help of lasers. This procedure effectively treats wrinkles, scars, pigmentation, and acne spots.

Laser skin resurfacing is of two types:

Ablative:

Ablative laser treatment removes the outermost layer of the skin and enhances the appearance of the formation of new skin. These kinds of treatments have more remarkable results than non-ablative treatments. For example, an Erbium YAG laser is an ablative laser treatment.

Non-ablative:

Non-ablative laser treatment does not remove the outermost layer of the skin. Instead, it causes an injury (thermal) to the skin, which promotes collagen and elastin production. Therefore, these treatments have a low potential for side effects compared to ablative therapy. However, additional treatments are required in conjunction with non-ablative treatment to get the desired results.

In addition, based on the extent of the treatment area, laser treatment can involve an entire field or a fractional area of the skin. In full field treatment, the complete treatment area is covered. However, in fractional laser treatment, thousands of divided laser beams treat a fraction of skin at a time.

What Are the Indications of Erbium Yag Laser Resurfacing Treatments?

Erbium Yag laser resurfacing treatment can cure several skin conditions. It is used to treat solitary benign (non-cancerous) and malignant lesions. Below are the indications of this treatment:

• Skin wrinkles.

• Acne scars.

• Improving skin texture.

• Skin discoloration or uneven skin tone (dyschromia).

• Sun-damaged skin (actinic damage).

• To regain skin elasticity (skin laxity).

• Angiofibroma (a non-cancerous tumor).

• Actinic cheilitis (a precancerous lesion that occurs on the lip).

• Keloids (a thickened and raised scar).

• Pyogenic granuloma (non-cancerous lesion that appears on skin or mucous membrane)

• Neurofibroma (a type of nerve tumor that manifests under the skin)

• Skin tags.

• Rhinophyma (nasal deformity caused by expansion or multiplication of sebaceous gland).

• Sebaceous hyperplasia (enlargement of sebaceous glands)

• Xanthelasma (a yellow growth that occurs on or at the corners of the eyelids adjacent to the nose, which is completely harmless).

• Seborrheic keratoses (non-cancerous skin growth).

• For treating traumatic or surgical scars.

• Warts.

• Moles and other nevi.

What Are the Contraindications of Erbium Yag Laser Resurfacing Treatments?

There are some conditions where these lasers cannot be used:

• Presence of active infection (bacterial or viral).

• Presence of any inflammatory condition in the target area.

• History of keloids or hypertrophic scarring.

• Presence of ectropion (a condition of the eye where the lower eyelid turns outward).

• There is a high risk of skin depigmentation in patients with darker skin which tans easily (Fitzpatrick skin types IV to VI).

• If the patient has undergone oral Isotretinoin (acne medicine) therapy recently.

• Skin condition like morphea.

• Scleroderma.

• Skin lesions like vitiligo, lichen planus, and psoriasis.

• In case of extreme exposure to ultraviolet radiation.

• Presence of active herpes lesion or any other infection.

• If the patient has undergone chemical peel treatment recently.

• This treatment should not be done before any radiation therapy.

• If the patient has unrealistic expectations.

• Collagen vascular diseases and immunity disorders.

How Does Erbium Yag Laser Resurfacing Treatment Work?

These lasers destroy and damage the diseased cells of the target area of the skin by emitting a light of wavelength having high energy from the laser machine.

How Is Erbium Yag Laser Resurfacing Treatment Done?

Before the procedure starts, the doctor takes a detailed history of the patient’s past medical treatments, current medications, how much sun exposure the patient has on a daily basis, how frequently the patient uses sunscreen, and a history of skin cancer in the family.

• This procedure is done under local anesthesia to comfort the patient.

• The patient is given protective eyewear to wear.

• Pre-operative photographs are taken.

• After achieving the numbness of the target area, the laser machine is started, and beams are directed to the target area with a laser handpiece.

• The laser resurfacing is done with an Erbium Yag laser on the target area.

What Are the Precautions to Be Taken After Erbium Yag Laser Resurfacing Treatment?

• There might be minor redness, swelling, or bleeding in the operated area, which can be managed easily.

• After the procedure, patients are advised to apply ice-cold packs and petroleum ointment. This should be done immediately after the procedure in the clinic.

• Patients are strictly advised to have strict sun protection. Direct sun exposure after laser resurfacing can burn the skin and may result in hyperpigmentation which is called post-inflammatory hyperpigmentation (PIH). Sunscreen of minimum SPF- 30 should be used daily after this procedure.

What Are the Side Effects Of Erbium Yag Laser Resurfacing Treatment?

There are very few side effects of this procedure which can be listed as mild, moderate, and severe. Below are the side effects listed:

Mild Side Effects:

• Millia (small white bumps on the skin).

• Exacerbation of acne.

• Contact dermatitis (itching and redness of the skin).

All these mild side effects can be treated easily with medicines.

Moderate Side Effects:

• Infections like herpes simplex, candida, and impetigo.

• Extended redness of the skin.

• PIH (post-inflammatory hyperpigmentation).

• White patches.

Severe Side Effects: Though these side effects are very rare, they may occur in a few patients:

• Infections like Staphylococcal infection (bacterial) or disseminated herpes.

• A scar (hypertrophic scar) can be formed, which is thick and raised due to abnormal wound healing.

• Thickening of tissues (fibrosis).

• Ectropion can develop.

What Are the Advantages of Erbium Yag Laser Resurfacing Treatment?

• These treatments are less invasive as compared to chemical peeling and dermabrasion.

• Downtime is short. It is usually three to five days.

• Consumables are less expensive.

• Higher-precision.

• The underlying tissues are at low risk of residual thermal injury from this procedure.

• Low risk of getting persistent and prolonged redness and pigmentation changes.

• The results are highly significant.

Conclusion:

To conclude, Erbium Yag laser skin resurfacing is an effective treatment for several skin conditions and diseases. It can be used for esthetic and medical purposes as this procedure rejuvenate skin and removes wrinkles, spots, pigmentation, and scars. It also treats cancerous, precancerous, and non-cancerous skin lesions.

Not all patients can undergo this procedure as there are some contraindications, such as patients with active infections and some skin conditions. However, recovery is easy after this procedure, and the results are very significant with minimal complications.