Er:YAG erbium laser:how it renews the skin, from rejuvenation to acne scars and wrinkles
- The Er:YAG erbium laser (2940 nm) is absorbed by water in the skin 10 to 15 times more strongly than a CO2 laser. It removes a very thin layer with little heat around it.
- In fractional mode it creates thousands of micro-channels and leaves intact skin between them. The skin heals fast and builds new collagen from within.
- There are several depth levels: gentle surface renewal, work on texture and fine lines, and deeper work on acne scars and wrinkles.
- For acne scars a result usually shows after 3 to 4 sessions about two months apart. The depth and the number of sessions are set at the diagnosis.
What is the Er:YAG erbium laser
The erbium laser (Er:YAG, erbium-doped yttrium aluminium garnet) is an ablative laser with a wavelength of 2940 nm. That is right where water in the skin absorbs light most strongly. In a comparison study the water absorption coefficient was about 12,000 versus 800 for a CO2 laser, roughly 15 times higher.
What does that mean in practice? The energy does not spread deep or sideways. It vaporises a very thin layer of cells and stops. That is why it is sometimes called a laser peel or "cold ablation": the skin renews without burning what is around it.
With each pass the erbium laser removes only a few microns and leaves a narrow heat zone of tens of microns. With CO2 that heat zone is much wider. So after erbium there is less long-lasting redness and a lower risk of colour changes in the skin.
How the erbium laser renews the skin
Skin has a clever repair system. When a tiny, controlled wound appears, the body sends cells that build new collagen and elastin. This is the basis of every laser skin resurfacing treatment.
In fractional treatment the laser does not remove the whole top layer. It makes thousands of hair-thin micro-channels, and intact skin stays between every two channels. That intact skin heals the channels very quickly, so recovery is much shorter than with full resurfacing.
The fractional concept was first published in 2004 and has since become the standard. In a study of fractional erbium, patients returned to their routine within about 4 days, and most saw improvement in the wrinkles around the eyes.
The result does not end on the day of treatment. Collagen keeps building for weeks and months, so the skin looks better month after month.
Skin rejuvenation in Tel Aviv →Depth levels: not every erbium treatment is the same
The erbium laser can be set to different depths. The deeper the work, the stronger the result and the longer the recovery. This is exactly where the personal diagnosis comes in.
| Level | What we do | Good for | Recovery |
|---|---|---|---|
| 1 | Gentle surface renewal | Tired skin, uneven tone, pores, glow | Light redness, same day |
| 2 | Fractional micro-channels | Texture, fine lines, shallow scars | Redness 1 to 3 days |
| 3 | Deeper micro-channels | Acne scars, deeper wrinkles | Redness and peeling for a few days |
We don’t publish the exact settings, because they are chosen for each skin separately: skin thickness, skin tone, scar type and how the skin reacted last time.
Taletsky Method: a personal protocol →Facial rejuvenation and tired-looking skin
Sun, years of shaving, screens and short nights take their toll: the skin looks grey, pores stand out, and fine lines around the eyes and on the forehead start to stay.
Facial skin rejuvenation with the erbium laser renews the top layer and wakes up collagen production. Right after the session the skin looks fresher and brighter, and texture improves step by step from session to session.
The big advantage: it is your own collagen, with no injections and no "done" look. People see that you look good, not that you had something done.
About skin renewal treatment →Acne scars: where erbium is especially strong
Acne scars are dents in the skin where acne destroyed collagen. A cream cannot fill such a dent. A fractional laser works differently: it smooths the edges of the scar and builds new collagen at its base.
In studies, improvement in acne scars comes over a series of sessions. In one study, after two sessions two months apart, more than half of the erbium-treated sides improved by over 50%, similar to a CO2 laser. In another, after 4 sessions, the scar score dropped by about 44%.
At our clinic the result usually shows after 3 to 4 sessions about two months apart. For deep rolling scars we do not promise completely smooth skin. What can be achieved is clarified at the diagnosis.
Deep wrinkles: what erbium does and what it doesn’t
Fine lines and wrinkles around the eyes respond very well to erbium resurfacing. Wrinkles around the mouth also improved in a long-term study, and the improvement lasted more than a year.
Very deep wrinkles and folds, like the fold from the nose to the mouth, are not only about the skin. There is also volume loss and muscle movement. A laser improves skin quality and softens the wrinkle, but it does not restore volume.
So at the diagnosis we say honestly what the laser will improve and what it won’t. No surprises and no empty promises.
Before and after results →Erbium vs CO2: what is the difference
The two most common ablative lasers are erbium and CO2. Both renew the skin, but in different ways:
| Erbium Er:YAG | CO2 | |
|---|---|---|
| Wavelength | 2940 nm | 10,600 nm |
| Absorption in water | 10 to 15 times higher | Baseline |
| Heat zone around | Narrow (tens of microns) | Wider |
| Long-lasting redness | Less | More |
| Deep wrinkles | Good, with several passes | Slightly stronger |
For Mediterranean, tanned or darker skin, like most clients in Tel Aviv, the key point is colour change after treatment. Studies show the risk goes down with lower density and longer gaps between sessions. That is exactly what a personal diagnosis allows.
What an erbium treatment looks like
Diagnosis. We look at the skin, the tone, the type of scars or wrinkles, and decide on the depth level and the number of sessions.
Treatment. The eyes are protected with goggles and the laser works area by area. The gentle treatment hardly hurts. Deeper work feels warm and prickly.
During treatment
The micro-channel grid right after
A few minutes later: glowAfter. After the gentle treatment the skin burns like after the sun for about 30 to 40 minutes, then it passes. After deeper work on scars there are a few days of redness and peeling. SPF 50 every day and no direct sun.
Prices →When it is not the right time
Before an erbium laser treatment tell us about: active herpes or skin inflammation, isotretinoin (Roaccutane) in recent months, a fresh tan, a tendency to raised scars (keloids), and medication that increases sun sensitivity.
In such cases we postpone the treatment or choose another route. Skin safety comes first.
When is the best time for erbium
The most convenient time is autumn and winter: less sun, easier aftercare and a lower risk of spots. A series that starts now is finished before summer.
Prices and packages →Frequently asked questions
Does erbium laser treatment hurt?
The gentle treatment hardly hurts, and a few minutes later the skin burns like after the sun for about 30 to 40 minutes. Deeper work feels warm and prickly.
How many erbium sessions do I need?
For rejuvenation the skin looks fresher after the first session and the result builds up. For acne scars a result usually shows after 3 to 4 sessions about two months apart.
What is the difference between erbium and CO2?
Erbium is absorbed by water more strongly and leaves less heat around, so recovery is faster and there is less long-lasting redness. CO2 is slightly stronger on deep wrinkles.
Can I go back to work after erbium?
After a gentle treatment, yes, the same day. After deeper work on scars, plan for a few days of redness and peeling.
Is the erbium laser suitable for darker skin?
Yes, with adjustment. On darker or tanned skin we work more carefully to lower the risk of spots, which is why we always start with a diagnosis.
How much does an erbium treatment cost?
Facial rejuvenation costs 1,800 ₪* per session and acne scar treatment 1,100 ₪* per session. There are packages of 3 and 5 sessions.
Want to know which erbium level suits your skin?
Personal diagnosis: we look at the skin, explain what can be improved, how many sessions you need and what it costs.*
Book a consultation on WhatsAppPrices* The final price is set after a personal skin diagnosis at the clinic, depending on the scope of treatment. Prices include VAT.
Scientific sources
The facts in this article are based on studies published in medical journals:
- Janik JP et al. Laser Resurfacing. Seminars in Plastic Surgery, 2007.
- Hohenleutner U et al. Fast and effective skin ablation with an Er:YAG laser: determination of ablation rates and thermal damage zones. Lasers in Surgery and Medicine, 1997.
- Khatri KA et al. Comparison of erbium:YAG and carbon dioxide lasers in resurfacing of facial rhytides. Archives of Dermatology, 1999.
- Manstein D et al. Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers in Surgery and Medicine, 2004.
- Tannous ZS et al. Micro-fractional ablative skin resurfacing with two novel erbium laser systems. Lasers in Surgery and Medicine, 2008.
- Tanzi EL et al. Side effects and complications of variable-pulsed Er:YAG laser skin resurfacing. Plastic and Reconstructive Surgery, 2003.
- Sanniec K et al. Long-term assessment of perioral rhytide correction with erbium:YAG laser resurfacing. Plastic and Reconstructive Surgery, 2019.
- Manuskiatti W et al. Comparison of fractional erbium-doped YAG and carbon dioxide lasers in resurfacing of atrophic acne scars in Asians. Dermatologic Surgery, 2013.
- Dai R et al. Comparison of 1064-nm picosecond laser and ablative fractional 2940-nm Er:YAG laser for atrophic acne scars. Frontiers in Medicine, 2023.
- Hu S et al. Ablative fractional erbium-doped YAG laser with coagulation mode for the treatment of atrophic acne scars in Asian skin. Dermatologic Surgery, 2011.
- Wat H et al. Fractional resurfacing in the Asian patient: current state of the art. Lasers in Surgery and Medicine, 2017.
