Use of Er:YAG laser for benign skin disorders

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Abstract
The Er:YAG laser is of special interest in dermatology and cosmetic surgery since it ablates and cuts tissue with surgical precision with minimal collateral thermal damage due to the wavelength of the Er:YAG radiation (2,940 nm), which is strongly absorbed by liquid water in tissue. The study was designed to establish optimal laser parameters for treating various skin disorders. Sixty-four patients were treated for benign skin disorders: seborrhoic warts, plane warts, milia, xanthelasma palpebrarum, hidradenoma, chloasma, senile lentigo, epidermal naevi, actinic keratosis, fibroepithelial papillomata, scars. The lesions were irradiated with single pulse laser energies 100–1,000 mJ, repetition rates 2–10 Hz, and spot diameters 2–8 mm. Epidermis was effectively removed on a layer-by-layer basis. For the ablation, energy densities higher than 2.5 J/cm2 were required. If bleeding appeared, the hemostatic effect was achieved by irradiating the bleeding surface with few Er:YAG laser pulses of lower power density (0.5–1.5 J/cm2). Healing was excellent and without apparent scarring. It was established that Er:YAG laser with properly selected parameters offers a tool for tissue ablation and/or coagulation. The Er:YAG laser was found to be a perfect option for effective treatment of benign skin disorders. Lasers Surg. Med. 21:13–19, 1997.