Erbium Laser Vs Fraxel Laser for Skin Damage?

Generally speaking, we would agree with the recommendation. The reason we prefer the Erbium over Fraxel is that it resurfaces 100% of the skin. Fraxel resurfaces only a portion of the skin. We have met with many patients that have undergone Fraxel treatments and most of them are disappointed with the results. Whether this is because of the expectations that were set prior to the treatment or because of the actual results, we are not sure. We do know one thing for sure. Those patients that are happy with their Fraxel results report 5-7 days of redness and swelling. This is the same recovery time for the Erbium resurfacing procedure. For the same amount of downtime, we suggest resurfacing 100% of the tissue (Erbium) vs. a much smaller % (Fraxel).

I would place the Erbium:YAG microlaser peel and the Fraxel in the same category in terms effect.  The deep Erbium:YAG is in another category all together and would be a different discussion.  Below is a list of pros and cons.

Fraxel

Pros


minimal downtime (3-5 days)

can be done in the office with topical anesthesia (still hurts like a mother!)

mild to moderate effect on wrinkles

Low risk of causing scarring or pigment irregularities


Cons


see above, hurts like a mother

expensive

mild to moderate effect on wrinkles

need to repeat, often sold in packages of 3 because of this

no effect on pigment irregularities because of the entire surface is not covered


Erbium:YAG microlaser peel

Pros


minimal downtime (3-5 days)

can be done with topical anesthesia in the office (much less painful than Fraxel)

mild to moderate effect on wrinkles (probably slightly less effective than Fraxel, but not much different)

low risk of causing scarring or pigment irregularities (can even be done on those with a darker complexion)

inexpensiver ($400 in my office)

better effect on pigment problems because the entire surface is resurfaced


Cons


mild to moderate effect on wrinkles

often sold in packages of 3 because of this


Hope this list helps to figure out the best choice for you.  Both modalities have minimal effect on pore size.

Thank you for your message! Both options are great to help with overall skin rejuvenation but they do work differently. Fractional CO2 laser resurfacing only targets portions of the skin, leaving healthy skin behind to help heal the targeted skin. The Erbium laser treats the entire area and typically multiple treatments are required. 

The Fraxel and Erbium lasers are very different and each have it's place.  The Erbium is much more aggressive and has many more side effects and down time. I much prefer my Fraxel laser for what you are describing.  If you have minor sun damage and fine lines and pores that you want treated you will have amazing results with almost no down time. I love the Fraxel laser. I agree that you must find someone very experienced in cosmetic dermatology to obtain the best results!

These are very different lasers and are difficult to compare. The ideal study would be one where one half of the side of the face is treated with one laser and the other side with the other laser.  This is unlikely to happen in a IRB approved study due to the inherent differences in the lasers.  What you should know is that they are different wavelengths and so their properties are not the same.  It is well known scientifically that erbium yag has a higher affinity for water than does CO2 and so it can specifically target the cells you are treating with less collateral damage. That is to say that although both lasers could be set at levels that can scar and burn people, or even levels that you would barely feel, the erbium yag is more efficient at removing tissue precisely.  What is best is to keep in mind is that, in the right hands,  nice results can be achieved with either laser. The downtime, cost, pain, number of treatments, risks of scarring and pigment changes are different with these lasers and should be discussed with your doctor before treating. It might even be best for you to meet with one doctor with one laser and another with the other laser and ask them the same set of  questions, compare prices, amount of pain with the treatment, risks of scarring and discoloration of the skin, downtime for healing and end results.  Always ask to see pictures if possible. Preferably ones that are not from the laser companies but rather their own patients. Then ask as many questions as you need to be comfortable you are with 1. the right doctor 2. with the right laser 3.and have the right expectations for your treatment.