Some skin concerns sit too deep for anything that works on the surface. Etched lines around the mouth and eyes, acne scarring, and years of accumulated sun damage are structural changes in the skin, and improving them means removing the damaged layers so new tissue forms in their place.
Erbium laser resurfacing at Aesthetic Skin & Laser Center in Pittsburgh, PA, does exactly that, with markedly less collateral heat than a CO2 laser. That difference is the reason people choose it: comparable resurfacing power, shorter recovery, and lower pigmentation risk. Dr. Barad treats lines, sun damage, and scarring around the eyes and mouth, and on the neck, chest, and hands.
Erbium laser resurfacing is an ablative treatment that removes the outer layers of damaged skin in a controlled way, prompting the body to heal with new, smoother tissue. The Erbium: YAG wavelength is absorbed almost entirely by water in the skin cells, which is what makes it precise.
That water absorption is the whole story. Because the energy is taken up so efficiently at the surface, it vaporizes the targeted tissue without much heat spreading into the skin beneath. Less residual heat means less inflammation, faster healing, and a lower risk of the pigmentation changes that follow more thermal treatments.
The laser can be set superficially for fine lines and texture, or more deeply for etched wrinkles and scarring. That range is why the same device suits a patient wanting a few days of recovery and one accepting a couple of weeks for a more substantial result.
Erbium laser resurfacing is FDA-cleared for skin resurfacing. Its wavelength sits at a peak of water absorption, so when the beam reaches the skin, the water in the cells absorbs the energy almost immediately, and those cells are vaporized precisely.
This is where Erbium and CO2 genuinely differ, and it is not a question of one being newer. Both have been in aesthetic use since the 1990s. CO2 is absorbed by water less efficiently, so more energy converts to heat that spreads into surrounding tissue. That residual heat contributes to CO2’s tightening effect, and it is also why CO2 involves longer recovery and carries more pigmentation risk. Erbium trades some of that thermal effect for a cleaner ablation and a faster return to normal.
Depth is selected by your provider for the concern being treated. Topical numbing is applied first, and a session runs from 30 minutes to around two hours depending on the area. Once the treated layers have been removed, healing produces new tissue at the surface while collagen rebuilds underneath over the following months.
An ablative treatment that removes damaged tissue rather than working around it, which is what etched lines and scarring require.
Efficient water absorption means the energy does its work and stops, rather than spreading into surrounding tissue.
For comparable resurfacing, the return to normal is meaningfully faster.
Less thermal injury means less risk of post-inflammatory hyperpigmentation, which matters most for deeper skin tones.
The same laser treats light texture and deep scarring, with recovery scaled accordingly.
Precision makes it usable around the eyes and mouth, where thin skin limits more aggressive options.
Neck, chest, and hands are all treatable, with settings chosen for thinner skin.
Removed damage does not return, and results hold for years with sun protection.
Erbium is used wherever sun damage, lines, or scarring have accumulated, including areas where thinner skin rules out more aggressive resurfacing:
Complete resurfacing, planned at a depth appropriate to your concerns and the recovery you can accept.
Horizontal lines and texture across a broad, flat area.
The periorbital area, where skin is thin, and crow’s feet and crepiness show early. Erbium’s precision suits it well.
Where acne scarring concentrates and sun damage accumulates.
Texture, enlarged pores, and sun damage on one of the most exposed areas of the face.
The vertical lines around the mouth, which respond to resurfacing better than to anything applied topically.
Treated as part of the perioral area or alone, and a classic indication for this laser.
Texture and scarring through the lower face.
Including the transition to the neck, where tone and texture changes become visible.
Thinner skin requiring conservative settings, treated where crepiness and sun damage have built up.
Where sun damage often shows earlier and more obviously than on the face.
Age spots, crepey texture and sun damage, and one of the most requested non-facial areas.
This treatment addresses concerns that involve the structure of the skin rather than only its surface:
Good candidates are adults with etched lines, acne or surgical scarring, sun damage, or textural change who want a meaningful result and can plan around recovery. Erbium suits patients who want resurfacing power without CO2’s longer downtime, and patients with deeper skin tones who have been advised against more thermal resurfacing.
Antiviral cover comes first for facial treatment. Ablative resurfacing around the mouth or across the face can reactivate herpes simplex even in patients who have never had a visible outbreak, so antiviral medication is prescribed beforehand as standard. This is not optional, and it is not a formality.
Treatment is not performed during pregnancy or breastfeeding, or where there is active infection or open skin in the treatment area. Recent isotretinoin use requires a waiting period before ablative resurfacing, and your provider will confirm the interval. A history of keloid or hypertrophic scarring needs discussion first. Recent sun exposure, sunburn, or self-tanner will postpone a session. Deeper skin tones are treated with adjusted settings, and while Erbium carries lower pigmentation risk than CO2, lower is not zero, so that conversation happens properly at consultation.
Topical numbing is applied and left to take effect, which for a full face takes around 30 minutes. Deeper treatments may need additional anesthesia, discussed in advance.
The laser is then passed over the treatment area in sections. Most patients describe heat and a snapping or prickling sensation rather than sharp pain. A small area such as the upper lip takes about 30 minutes; a full face with deeper settings can run closer to two hours.
Immediately afterward, the skin looks red and feels hot and tight, comparable to a significant sunburn. Ointment is applied, and specific wound care instructions are given, which matter more on an ablative treatment than on almost anything else. You will leave with a clear plan for the following week.
This depends entirely on depth, which is why a single figure is misleading and why you may have seen different numbers quoted.
Superficial Erbium treatments, used for fine lines, texture, and light sun damage, generally involve a few days of redness and light flaking, after which most patients feel comfortable in public. Deeper treatments, used for etched wrinkles and significant scarring, involve one to two weeks before the skin has fully closed, with pinkness fading for some weeks after that.
The trade-off is straightforward: more depth means more result and more recovery. Your consultation decides where on that range your treatment sits, based on what you want to change and how much time you can give it. Nobody should book this without knowing which end of that scale they are on.
Resurfacing removes damaged tissue, and that tissue does not come back. The lines, scarring, and sun damage treated are improved durably, and many patients maintain their results for years.
What continues is aging and sun exposure. New sun damage forms if skin is unprotected, and skin keeps changing regardless of treatment, so how long your result holds depends heavily on daily sun protection and skincare. Patients who protect their skin consistently keep their results far longer than those who do not, and that is within your control rather than the treatment’s.
The question we are asked most is how Erbium compares with CO2, and it is the right question to ask:
Treatment | How It Works | Recovery | Best Suited To |
|---|---|---|---|
Erbium Laser | Ablative, absorbed by water with minimal residual heat | Days to 2 weeks by depth | Lines, scars, and sun damage with shorter recovery and lower pigment risk |
eCO2 | Ablative fractional CO2 with more thermal spread | Around a week or more | Deeper wrinkles and scarring where tightening matters |
MOSAIC | Non-ablative fractional laser | Minimal | Texture and tone without removing tissue |
LaseMD Ultra | Fractional laser with topical delivery | A few days | Pigment and texture with light downtime |
Tixel | Thermo-mechanical heat transfer | Minimal | Gentle resurfacing, including around the eyes |
Neither Erbium nor CO2 is newer than the other; they simply behave differently. CO2 leaves more residual heat, which adds a tightening effect and costs you recovery time and a higher pigmentation risk. Erbium ablates more cleanly, which means a faster return to normal and better suitability for deeper skin tones. If skin tightening is your main goal, CO2 may serve you better. If resurfacing with less downtime is your goal, Erbium is the reason this page exists. MOSAIC, LaseMD Ultra, and Tixel sit further toward the gentle end again.
Physician-led ablative treatment: Depth and settings are chosen by Dr. Roxana Barad, a board-certified physician with over 20 years in aesthetic medicine and a member of the American Society for Laser Medicine and Surgery.
The right laser for your skin: With several resurfacing devices available here, the recommendation comes from matching your concern, tone, and available recovery time rather than from what is in the room.
Proper screening before treatment: Antiviral cover, skin tone assessment, and medication history are handled before anything is booked, because ablative treatment demands it.
Honest about recovery: You will be told which end of the recovery range your treatment sits at before you commit, not afterward.
Aftercare that is actually supported: Wound care instructions and follow-up, because on an ablative treatment the healing period determines the result.
Part of a full plan: This sits alongside our other laser and energy treatments so treatment can be sequenced rather than sold individually.
Aesthetic Skin & Laser Center offers Erbium laser resurfacing in Pittsburgh, PA, welcoming patients from across the region, including:
It depends on depth. Superficial treatments involve a few days of redness and light flaking. Deeper treatments take one to two weeks for the skin to close, with pinkness fading over several weeks afterward. Your provider will tell you which applies to your plan before you book.
Topical numbing is applied beforehand, and deeper treatments may require additional anesthesia. Most patients describe heat and a prickling sensation during treatment rather than sharp pain. Afterward, the skin feels hot and tight, similar to a significant sunburn, and is managed with the aftercare provided.
Improvement is visible once the skin has healed, and continues developing for months as collagen rebuilds underneath. The result at three months is better than the one at three weeks.
Often one deeper treatment is enough, though a series of lighter sessions is an alternative for patients who prefer less downtime each time. Scarring and significant sun damage may need more than one regardless. Your provider will set the plan at consultation.
Yes, though sequencing and spacing matter considerably with an ablative treatment. Nothing else should be done to the skin while it is healing. Your provider will plan the order and the intervals.
Peeling and crusting as the skin sheds and new tissue forms, followed by pinkness that fades gradually. Wound care instructions are provided, and following them closely matters more here than on any non-ablative treatment.
As with any ablative treatment, risks include infection, prolonged redness, changes in pigmentation, and scarring, though scarring is uncommon with appropriate settings and aftercare. Reactivation of herpes simplex is a specific risk, which is why antiviral medication is prescribed beforehand. Your individual risk is reviewed at consultation.
Cost depends on the area treated and the depth of the treatment, since a perioral area and a full face at deeper settings are very different appointments. Pricing is confirmed at consultation once the plan is set. Patient financing is available.
It carries lower pigmentation risk than CO2, because less residual heat means less inflammation and therefore less post-inflammatory hyperpigmentation. That is a genuine advantage. It is not risk-free, so settings are adjusted for your skin tone, and your provider will discuss the risk honestly rather than dismissing it.
Both are ablative, and both have been in use since the 1990s, so neither is newer. Erbium is absorbed by water far more efficiently, ablating tissue with minimal residual heat. CO2 leaves more heat behind, which produces a tightening effect but also longer recovery and higher pigmentation risk. Erbium is the choice when recovery time or skin tone matters; CO2 when tightening is the priority.
Beforehand, start the antiviral medication prescribed, avoid sun and self-tanner for two weeks, pause retinoids and acids, and arrange your recovery time. Afterward, follow the wound care plan exactly, do not pick at healing skin, stay out of the sun, and wear daily sunscreen for months once healed.
If lines, scarring, or sun damage have stopped responding to gentler treatments, resurfacing is the step that reaches them. The useful conversation is about depth: how much change you want, and how much recovery you can give it.
Visit us at 4312 Penn Ave, Pittsburgh, PA 15224, call 412-683-3358, or contact us online to schedule with Dr. Barad and the team.
