Studies tend to show that fractional ablative laser erbium YAG and non-ablative laser erbium glass are effective and safe for the treatment of skin spots and acne, but most of these studies do not provide insight into the long-term efficacy and safety profiles of these devices when used for these cosmetic indications. This is according to a review study findings published in Lasers in Medical Science.
For this systematic review, researchers in South America identified 338 randomized clinical trials that examined the efficacy and safety of non-ablative fractional erbium glass laser (wavelengths of 1540 and 1550 nm) and ablative fractional erbium YAG laser (wavelengths of 2940 nm) for facial rejuvenation, skin spots, and atrophic acne scar treatments. A total of 17 articles met the inclusion criteria (n=453), including 7 that discussed atrophic acne scars, 1 that involved skin spots, and 9 that involved photoaging.
The follow-up time for all studies included in the review ranged from as little as 1 day to a maximum of 6 months. According to these studies, both ablative and non-ablative fractional erbium lasers at wavelengths of 1540, 1550, and 2940 nm were considered effective and safe for the treatment of skin spots, atrophic acne scars, and facial skin rejuvenation during the short term. In addition, these treatment approaches reduced wrinkles, acne scars, and skin spots.
The most prominent adverse effects after these procedures included postoperative erythema and edema. The duration of these effects ranged from 24 hours to 7 days, with a greater incidence of adverse effects observed with ablative fractional erbium YAG laser at 2940 nm. A total of 3 studies reported post-inflammatory hyperpigmentation after fractional laser application. None of the studies included in the review reported permanent adverse events associated with erbium YAG laser therapy.
Limitations of the systematic review were the inclusion of studies with limited follow up as well as the variability in the studies’ methodological qualities.
Because of these limitations, the researchers wrote that additional “research is needed with better methodological standardization and a follow-up that covers a longer period of time in order to evaluate the possibility of permanent adverse effects.”
Modena DAO, Miranda ACG, Grecco C, Liebano RE, Cordeiro RCT, Guidi RM. Efficacy, safety, and guidelines of application of the fractional ablative laser erbium YAG 2940 nm and non-ablative laser erbium glass in rejuvenation, skin spots, and acne in different skin phototypes: a systematic review [published online May 29, 2020]. Lasers Med Sci. doi: 10.1007/s10103-020-03046-7