Ebrium Laser Resurfacing Vs Co2 Laser Resurfacing?

I am planning to get one of these treatments, to treat my acne scars, sun damage/uneven tan. I would consider the degree of my skin condition as moderate acne scar and sun damage. My question is which of these two lasers will get the job done effectively and significantly. What are the pros and cons of each? I heard that erbium laser is more effective and less risky than co2 laser (as co2 can cause bleaching). What is the typical price range of each. Thanks

Hi There,

Here is a link to the average cost of Laser Resurfacing reported by our community members.

Hopefully this helps!

Doctor Answers 8

Fractional CO2 is my current treatment of choice

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I think the question is really between 100% resurfacing methods with either Erbium or CO2 vs. fractional treatment.  I have performed all three over the years.  Erbium is better for superficial characteristics and does not cause enough contraction to improve the scars.  100% CO2 is very effective, but has prolonged reddness and downtime and about a 15% chance of permanent lightening of the skin.  In my opinion that is too high and only worth the risk if you are very fair.  Fractional CO2 gives you the ability to go deep, very low risk of hypopigmentation and easy recovery of about 8 days.  It can be repeated in 6 months to a year for better results.  I use the Candela CO2RE system and it is very successful but there are many good lasers out there.  

Nothing will take the place of a consultation face to face with you, but I hope this helps!

Philadelphia Dermatologic Surgeon

CO2 more effective

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You are absolutely correct in your evaluation. CO2 is very effective but carries more risk of pigment change, whereas erbium is more superficial.

Brian K. Machida, MD, FACS
Ontario Facial Plastic Surgeon
4.1 out of 5 stars 24 reviews

Melarase creams and CO2 laser in Santa Monica

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Our office recommends the co2 laser for ablative resurfacing over the skin.  Most patients will also begin Melarase creams in addition to minimize PIH.

Raffy Karamanoukian MD FACS

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

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Ebrium Laser Resurfacing vs Co2 Laser Resurfacing

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Thank you for your question. The price should be very close, and the risks are similar.  If you are using fractional technology in both, and similar depth of treatment, the risks are similar.  We prefer the CO2 laser as we see a more profound tightening of the tissue.   To improve just the texture, they re both effective.  Be certain to be under the supervision of a board certified dermatologist or plastic surgeon with expertise in laser surgery and darker skin types for the most effective and safe treatments. I hope this helps.

Comparing 2 laser resurfacing treatments

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Erbium laser resurfacing is not as deep, but also has less down time and less risks. CO2 laser will go the deepest, give you the most down time, and carries greater risk of scarring and especially the loss of pigment ("depigmentation"). For this reason, fractionated laser resurfacing is significantly more popular and safer these days. Best to speak with your dermatologist about the best option for your particular skin type and problems, and to go to a reputable medical clinic for your treatments. Dr. Benjamin Barankin, Toronto Dermatology Centre.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon

CO2 laser vs Erbium laser

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CO2 laser is still the gold standard for skin resurfacing.  The risk of hypopigmentation or skin bleaching is much lower with modern fractional laser techniques.  Traditional erbium lasers are not as effective as the CO2 laser.  The Sciton erbium laser makes the erbium laser behave more like CO2.  I prefer the DOT CO2 laser which allows the doctor to precisely control all aspects of the laser treatment.  In skilled hands, fractional CO2 laser is the gold standard for skin resurfacing.

Richard Ort, MD
Lone Tree Dermatologic Surgeon
5.0 out of 5 stars 28 reviews

Dual mode erbium laser is best for skin resurfacing.

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1)  CO2 can certainly cause bleaching.  The erbium laser made by Sciton which can deliver both long and short pulses is very safe and effective.

2)  It sounds like you need fairly deep resurfacing, so you should expect a recovery period as long as a week.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Fraxel CO2 vs Fraxel Erbium vs. Ablative CO2 vs. Ablative Erbium

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Typically, the fully ablative procedures take more time to heal and the Fully ablative CO2 tends to be done deeper than the ablative erbium laser unless the erbium is used for many passes. There is more tightening of dermal tissue with CO2 than Erbium. There is a greater tendency for permanent lightening of skin color with the C02 fully ablative than the fractional CO2 and that has a slightly greater chance of lightening than the fractional erbium which rarely, if ever, has been reported to cause permanent lightening. Any laser has a risk of scarring, especially if a secondary infection occurs post-operatively, but the risk is greater with fully ablative CO2.

It is not unusual that a series of fractional laser treatments cost more than one ablative treatment.

In consultation, a physician should determine which is the best laser to provide a good result while offering the patient the type of treatment plan that is best for them including the number of treatments and down-time per treatment.

The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.