April 23, 1999

The erbium:YAG (Er:YAG) laser can be as effective as the standard CO2 laser for the removal of wrinkles with fewer side effects, according to a study from the Wellman Laboratories of Photomedicine at the MGH. The report in the April Archives of Dermatology demonstrated that, while the Er:YAG required more "passes" of the laser to achieve the same result as the CO2 laser, patients experienced less reddening of the skin and significantly faster recovery time with Er:YAG treatment.

"It is not unusual for people to take two weeks or more to recover from CO2 laser resurfacing, which makes the procedure inconvenient for many working people," says Khalil Khatri, MD, of the Wellman Labs, the paper’s first author. "The shorter recovery time needed for Er:YAG treatment means it might be a better option for many people, especially those with relatively superficial wrinkling."

The CO2 laser has been used for laser resurfacing – removal of wrinkles and other signs of sun damage by removing the skin’s outer layer – since the early 1990s and is considered the "gold standard" of treatment. The Er:YAG laser was first used for treatment of wrinkles and other skin blemishes at the MGH Wellman Labs and was approved by the FDA for laser resurfacing in 1997. This study is the first to compare directly the effectiveness and long-term results of the two treatment modalities.

In 21 volunteer patients, laser resurfacing was carried out using the CO2 laser on one side of the face and the Er:YAG laser on the other side. Evaluation of the overall results found that removing equal depth of skin layers resulted in similar improvement in wrinkles, with Er:YAG treatment resulting in fewer side effects and quicker recovery times. "It’s clear that the two types of laser treatment have their own advantages," says Khatri. "I describe the overall effects of both to my patients and let them choose which is best for their particular needs."

The paper’s co-authors included R. Rox Anderson, MD; and Joop Grevelink, MD, PhD, of the Wellman Labs.