Er:YAG, colloquially called the erbium laser, is a 2940 nm laser whose light is absorbed in intracellular water 10 times more strongly than that of a CO2 laser. The higher light absorption of the Er:YAG laser allows for more precise action in the skin, with much less thermal damage to the surrounding tissue.

Compared to the CO2 laser, the collagen shrinkage is lower, so it has a slightly less pronounced effect on rejuvenation and wrinkle smoothing.  On the other hand, it is associated with less redness after the procedure and a shorter recovery time.

The Er:YAG laser can work to completely ablate the tissue with almost no thermal damage to the surrounding skin. By adjusting the device to allow longer pulse times, overheating and collagen shrinkage can be increased, bringing the effect very close to that of CO2 lasers. The recovery time is nevertheless still shorter.

Er:YAG laser – applied for the treatment and removal of superficial lesions 

The Er:YAG laser allows for extremely precise removal of the skin surface, i.e. in layers whose thickness is a few thousandths of a millimetre. The latter triggers the healing and regeneration of the skin, which stimulates the production of collagen in the dermis. The end result is smoother, firmer skin.

Er:YAG selectively absorbs water in the skin cells, thus allowing for extremely precise micron-size ablation – removing the epidermis layer by layer. The skin is then tightened, i.e. shrunk, stimulating the production of new collagen in the dermis. The end result, seen over time, is the creation of new skin which is smoother and firmer.

What skin lesions can be treated/removed with the Er:YAG laser?

• Acne scars
• Scars after surgery and trauma
• Scars from herpes and chickenpox
• Sun-damaged skin (wrinkles, sun spots, enlarged pores, elastosis)
• Mild to moderately deep wrinkles
• Uneven skin pigmentation (lentigo, ephelides, melasma)
• Seborrheic keratoses and other benign skin growths
• Some congenital vascular malformation

Effect depending on the settings of the Er:YAG laser:

• For superficial lesions, a short pulse time setting is used to allow removal without overheating the skin.
• For deep wrinkles, a long pulse time setting is used to allow the surrounding skin to overheat and stimulate collagen formation.
• Total ablation (removal of a thin layer of the entire skin surface, laser resurfacing) can be used on a smaller area to remove skin growths, or on a larger area (e.g. the entire face) where the aim is to rejuvenate the skin.
• Fractionated ablation is a mode of operation where the laser beam is applied to only a small part of the skin surface. The surrounding skin, which is unchanged, serves as a reservoir for rapid healing. The use of the Er:YAG (and CO2) laser in this way is now mainstream, as the recovery time is shorter and the side effects are rare compared to full ablation.

What are the side effects of the Er:YAG laser?

The side effects of the ER:YAG laser are mostly mild. Moderate or severe side effects are rare.

Mild side effects:

• the emergence of milia,
• aggravation of acne,
• contact dermatitis after the procedure (caused by the use of creams during the healing period).

Moderate side effects:

• a limited outbreak of herpes simplex, a bacterial or fungal infection,
• prolonged redness of the skin,
• transient over-pigmentation of the skin after inflammation,
• delayed hypopigmentation of the skin. 

More severe side effects:

• scarring of the skin (only occurs with full skin resurfacing),
• widespread infection with herpes simplex or bacteria.

Benefits of the Er:YAG laser

For selected skin conditions, we can perform very precise removal/treatment of skin lesions.

• Minimal thermal damage to the surrounding tissues, with shorter post-procedure skin redness and less risk of longer-lasting redness and/or skin pigmentation change.
• Less invasive than mechanical dermabrasion or medium and deep chemical peels.
• Short recovery period, which is shorter than CO2 laser treatment.

What is the difference between CO2 and Er:YAG lasers?

• Both lasers are ablative lasers which work by removing the top layer of the skin but they differ in the overheating of the surrounding tissue. In the case of the Er:YAG laser the latter can be minimal or almost very similar to that of the CO2 laser, depending on the pulse duration setting of the device. The longer the time, the more the skin overheats. A systematic review of comparative studies of the two devices in wrinkle smoothing has shown that the CO2 laser is slightly more effective.*, **
• The Er:Yag laser is safer for removing viral warts than the CO2 laser since viral DNA is not found in the smoke produced during the procedure.

*Kee-Hsin Chen,Ka-Wai TamA systematic review of comparative studies of CO

2 and erbium:YAG lasers in resurfacing facial rhytides (wrinkles) DOI:

10.1080/14764172.2017.1288261

** J B Newman 1 , J L Lord, K Ash, D H McDanielVariable pulse erbium:YAG laser skin resurfacing of perioral rhytides and side-by-side comparison with carbon dioxide laser DOI: 10.1002/(sici)1096-9101(2000)26:2<208::aid-lsm12>3.0.co;2-r

Appointments and further information

To book an appointment, contact us Monday to Friday from 8:00 to 16:00 on the following telephone number: 064 12 80 15 or send an e-mail: info@derma-rogaska.si