How safe and effective is erbium laser for skin resurfacing? (Photo)

Question

I'm 54 with pretty good skin, moderate sun damage but have noticed more fine lines and wrinkles under my eyes. I have had ipl but would like to dip my toe in a fractional treatment. Is erbium a good choice and can I ask to keep settings low for safety? I'm a wimp lol. Thank you in advance for responding. Including a photo to show fine concerns.

Andrew Campbell, MD · Answer

Fractionated erbium, though effective, is a pretty old technology. I would recommend the Halo laser. It has some erbium, but also has another laser that in non-ablative (doesn't vaporize the tissue, only heats it). The combination of lasers work synergistically to give a significant improvement to fine lines and wrinkles, texture, and even some improvement in the color of the skin. Downtime is minimal.

Andrew Campbell, M.D.
Facial Rejuvenation Specialist
Quintessa

Andrew Campbell, M.D.
Facial Rejuvenation Specialist
Quintessa

Kian Karimi, MD, FACS · Answer

An erbium laser such as TRL would be an excellent choice to address the fine lines around your eyes. The healing process is a bit more difficult than the IPL lasers, but it will provide you with amazing results. The procedure can be painful for some so I offer in office medication to help with the process given you have a driver to take you home. With the medication, most patients feel it is very tolerable. I would recommend having the procedure done with an expert that is able to provide a minimally painful experience without compromising results. I have my patients pre and post treat with Alastin skincare which has shown time and time again to speed up and enhance the recovery process. Going forward, I would recommend you to complete multiple in office consultations with board certified experts to discuss your ideal aesthetic goals. This way, they can better assess your face and create an ideal treatment plan for you.

Best of luck!
Kian Karimi MD, FACS

Best of luck!
Kian Karimi MD, FACS

Jason Emer, MD · Answer

you should get a formal consultation. pre and post treatment with peels and skincare.

at home peels like cosmelan, enlighten and aerify along with dermarolling (EmerageSkin roller with anteage AERIFY MD ampules weekly, see link) should be started now to prevent further aging.

For facial rejuvenation,  I would suggest a combination approach of 
1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel/halo Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8 for tightening of the skin
8) Vascular laser like vbeam/excel V or BBL forever young treatment every quarter (3-4 months)

Best, Dr. Emer.

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