Erbium Laser or CO2? Which gives more bang for the buck? Would a deep chemical peel work just as well?

we did the original study 20  years ago comparing CO2 and erbium laser- Basically one can achieve the same results with either laser; it's the depth of the procedure that really determines the downtime and results. A CO2 laser can be used so conservatively that you recover in 3 days, or and erbium laser can be applied aggressively and it can take 10 days to heal; in the right hands, both can deliver great results

CO2 is the best laser for scars, but Erbium is a great alternative. It may take a series of treatments to see improvements and to maintain. Keep in mind that a tailored combination approach will give you the most improvement with acne scars. I recommend getting a formal evaluation with an experienced cosmetic dermatologist and acne scarring expert. Best, Dr. Emer.

. Both the erbium and CO2 lasers are very good lasers. One is not "better" than the other. When choosing a laser it depends on what condition you need to treat, the patient's skin tone and texture, and how much recovery time the patient is able to tolerate.  The CO2 laser is considered an ablative laser versus the erbium which does not ablate the skin.  The more aggressive the laser the more recovery time is needed but it usually results in less treatments. Chemical peels can be combined with laser treatments. Again, it depends on what condition you want treated.  Many physicians do not offer  deep chemical peels as lasers give a more predictable result.  You should consult with an experienced provider who offers many different lasers/procedures  and can customize the treatments to your needs. 

In our practice, we used a fractionated CO2 laser (CO2RE by Candela) for skin resurfacing and have had good success with it. The results are dramatic. I prefer this laser over medium and deep chemical peels since the laser gives a more controlled and reproducible result, at least in my opinion and hands. 

The gold standard for laser resurfacing is the CO2 laser. But, it has a downtime of around 7 to 10 days. The erbium has less downtime, but not as good per most surgeons.