General or Local Anesthesia for Erbium Laser Resurfacing?

Here is a brief outline of what anesthesia is needed for the different uses of the Erbium:YAG laser


Microlaser peel- topical numbing cream, must be on for at least 30 minutes before starting

Fractionated laser- topical for most, some people will need more sedation.

Deep full-face laser peel- heavy IV sedation or general anesthesia with injected regional blocks


I have done a deep laser peel on small segments (i.e. lips or around the eyes) with just injected medication.  You would either be really tough or just a glutton for pain if you did the deep laser on the entire face without sedation.  Although this is a general outline, there are some people who are particularly anxious and need oral Valium, injected regional blocks or even general anesthesia for even a microlaser peel.  Remember that if this is a nightmare experience for all involved, it's unlikely you'll be happy no matter how good the results. 

We never use general anesthesia for resurfacing.  We use a combination of topical and local blocks.  If you can tolerate the locals given at the dentist, then you will do just fine without a general anesthetic.

I have performed thousands laser resurfacings, both CO2 and Erbium.  I have not seen the need to use general anesthesia since the introduction of the fractional lasers.  The most popular Erbium laser is the Fraxel Restore. It is a fractional laser and is easily done with a topical anesthetic in combination with oral sedation, typically Valium and Percocet.  General anesthesia is simply not necessary and introduces excess risk and cost.