Erbium Laser Resurfacing: Results, Recovery and Risks
What erbium (Er:YAG) laser resurfacing treats, how it compares with CO2, recovery time, complication rates by depth, and who is a good candidate.
Erbium (Er:YAG) laser resurfacing removes thin layers of skin to improve wrinkles, sun damage, texture and some scars. The short answer: erbium usually means a shorter recovery than CO2, especially for lighter treatments, but deeper treatments bring more downtime and more complications.
Erbium vs CO2
| Erbium (Er:YAG) | CO2 | |
|---|---|---|
| Role | Developed as an alternative to CO2 to reduce common complications (Weniger et al., Aesthet Surg J, 2020) | Described as the gold standard for ablative resurfacing (Agrawal et al., Facial Plast Surg, 2014) |
| Typical recovery | About one week (ASPS: recovery) | Generally up to two weeks (ASPS: recovery) |
| Sessions | Fractional erbium often needs 2 to 4 sessions (Mayo Clinic) | Traditional CO2 is often a single session |
What depth means for risk
A practice-based review of 8 years of full-field erbium treatments found (Weniger et al., Aesthet Surg J, 2020):
| Treatment depth | Complication rate |
|---|---|
| "MicroLaserPeel" (50 microns or less) | 10.1% |
| Deep resurfacing | 26.5% |
| Deep resurfacing around the mouth | 38.6% |
Deeper ablation meant more complications. These came from one surgeon's practice and one laser model, so rates elsewhere may differ.
What erbium treats
- Fine and moderate wrinkles
- Sun damage and uneven texture
- Some acne scars
- Certain pigment spots
Recovery
- Redness, swelling and itching at first; skin may ooze and crust after deeper treatments, then peel at about 5 to 7 days (ASPS: recovery).
- New skin is pink and gradually lightens over two to three months, sometimes longer (ASPS: recovery).
- Daily sunscreen after healing is essential.
Possible complications
Acne flares, infection, cold sore reactivation, darkening or lightening of skin, milia, prolonged redness, and rarely scarring (ASPS: recovery). People with darker skin tones have a higher risk of hyperpigmentation (Cleveland Clinic).
Who is a good candidate
- People with sun damage or wrinkles who want more than topicals can offer
- People who can plan for downtime and avoid the sun afterward
- People without active infection, and who've told the provider about cold sore history
Frequently asked questions
Is erbium safer than CO2? It was developed to reduce common complications, but deep erbium treatments still carry real risks.
Does it hurt? Numbing is used; deeper treatments may need more anesthesia.
How long do results last? Years, with sun protection, though skin keeps aging.
This article is for educational purposes only and is not medical advice. Talk to a board-certified dermatologist about your situation.
Sources
- Weniger FG et al. Full-field erbium:YAG laser resurfacing: complications and suggested safety parameters. Aesthet Surg J. 2020. PubMed
- Agrawal N et al. Ablative skin resurfacing. Facial Plast Surg. 2014. PubMed
- American Society of Plastic Surgeons. Laser skin resurfacing recovery
- Mayo Clinic. Laser resurfacing
- Cleveland Clinic. Laser skin resurfacing
