Pearl Erbium Laser Peels


The Pearl by Cutera is an Erbium:YSGG laser that provides multiple treatment benefits to the skin using a Laser Peel treatment method.  The Pearl has a computer guided scanning device that can be programmed to remove specific layers of tissue uniformly. Depending on the depth we are able to treat mildly to very aggressive to treat a variety of conditions ranging from age spots to deep wrinkles and scars.  This treatment has a rejuvenating and refreshing effect on the skin, enhancing a youthful appearance with an overall tightening effect. 

The Pearl yields similar results to Erbium Laser Peels to treat uneven pigmentation and superficial texture of the face, neck, and chest, with less down-time. We recommend a series of two-five treatments depending on desired result and original severity of the condition treated.

The Pearl can also be used to increase the results of traditional Photodynamic Therapy, Photorejuvenation and Fraxel® SR1500 Laser Treatments. This may be ideal for patients who do not have the time to commit to a series of Photorejuvenation treatments, and can tolerate extended downtime.
 
 
 
 

What is Pearl Erbium Laser Peels?


A series of treatments with the Pearl Erbium: YSGG, typically 1-3 treatments, will greatly reduce the appearance of uneven pigmentation and superficial texture of the face, neck, and chest.  The epidermis on the face has an average thickness of 110 microns.  Depending on the treatment settings, the Pearl Erbium: YSGG will ablate 10-30 microns of the epidermis and coagulate from 20-60 microns each treatment with residual heat going into the dermis. 

 

The Pearl can be used alone or to increase the results of traditional Photorejuvenation, Photodynamic Therapy, and Fraxel SR1200 Laser Treatments.  This may be ideal for patients who do not have the time to commit to a series of Photorejuvenation treatments and can tolerate extended downtime, typically 3-7 days.

 

Who is a candidate?


Good candidates for this procedure are people with sun damaged skin:  freckled, discolored, blotchy, and wrinkled or those with poor skin texture and/or large pores. 

 

People with darker skin types may not benefit from this procedure as the risks of hypo- or hyper- pigmentation may be too high and would do better to consider fractional resurfacing.  Patients who are pregnant or who have taken Accutane in the last six months cannot have these treatments.  Patients who are planning on being in the sun for an extended period of time after a treatment should postpone treatment until they can remain out of direct sun exposure for up to 6 months following treatments to reduce side effects and increase results.

What is Pearl Erbium Laser Peels like?


For your comfort during the treatment, we apply a topical anesthetic one hour prior to the procedure.  This will reduce the majority of the discomfort during these treatments. 

 

Because of the depth of the Pearl, we recommend prophylactic medications if you suffer from herpes simplex virus (HSV or cold sores).  Antiviral medication, Valtrex or Famvir, started two days prior to the treatment and continued five days after the treatment will help prevent the virus from becoming active.

 

During each treatment you will wear laser eye shields to protect your eyes during the treatment.  When treatments are performed near the eyes, on the eyelids, anesthetic drops will be placed in your eyes and corneal shields (plastic contacts) will be inserted.  You may need to be driven home as your vision will not accommodate for a couple of hours.  During the treatment you will hear a popping noise similar to a quick snapping, as the laser treats the skin.  At the end of the treatment we will apply skin care and give you instructions on what skin care to use during the weeks following your treatment.

 

Most patients have 3-6 days of downtime after the treatment.  Immediately following the procedure you may feel as if you have a bad sunburn (burning sensation), but this usually resolves 30-60 minutes after the treatment is over.  There will be redness and minor sloughing for up to a week following the treatment.  Use of the recommended skin care will speed up this healing process.  Usually after the first day or two, makeup can be applied to minimize the appearance.

 

Typically we recommend a series of 2-5 treatments performed monthly to achieve optimal results.  Maintenance treatments and topical products will also be necessary to maintain results. 

How does Pearl Erbium Laser Peels work ?


The Pearl Erbium: YSGG is an Yttrium Scandium Gallium Garnet laser emitting light at 2790nm.  This wavelength is highly absorbed by water.  The water in the tissue is vaporized during the treatment causing the skin up to 30 microns deep to be removed instantaneously.  Additionally, it coagulates the tissue from 20-60 microns deep.  This acts as a natural dressing and is shed after 3-4 days when it is no longer needed.  Finally residual heat extends into the dermis to stimulate collagen remodeling.

What type of equipment is used?


 

The Pearl Erbium: YSGG is a 2790nm Yttrium Scandium Gallium Garnet Erbium Laser made by Cutera.

What desired results can be expected?


Those patients who can tolerate the downtime associated with a more aggressive procedure will be able to appreciate the results of Pearl treatments which are ususally seen more quickly than with Photorejuvenation.  A series of 1-3 treatments will greatly reduce uneven pigmentation and improve overall skin texture and tone.
 

Patients who follow the recommended treatment and skincare program, with realistic expectations, are very pleased with their results. The skin is more radiant, with more skin clarity, even pigment, and less textural irregularities. 

Are there any negatives?


Discomfort during the treatment is minimized by application of topical anesthetic 60 minutes prior to treatment.  Most patients describe the post-procedure feeling as a bad sunburn, and it usually resolves in about an hour after the treatment.  Tylenol and ibuprofen may be taken as needed.

 

Redness and minor peeling will last from 3-6 days following the treatment.  Some swelling may occur in the first day or two.  Use of the recommended skin care following a treatment will help with this healing process.  Makeup may be used after the first day or two to minimize the appearance of these.

 

During the healing period and after the treatments, the area treated will be more sensitive to sunlight.  Proper sun protection should be worn at all times to minimize possible complication from sun exposure and to enhance treatment results. 

 

Although infections are extremely uncommon, bacterial, fungal, and viral infections can occur.  Patients with a history of cold sores should inform the office prior to treatment and begin an antiviral medication prophylactic ally prior to treatment.

           

It is important to keep the skin hydrated and moisturized while it is healing.  Specific skin care will be recommended to prevent the skin from drying out. 

           

Although extremely rare, scarring may occur.  This can range from depression(s) in the treated area to a keloid scar.  If scarring occurs, additional treatments may be needed to reduce their appearance.

           

Transient hyperpigmentation may also occur.  Using the recommended skin care and practicing proper sun avoidance will minimize this risk.  Hypopigmentation may also occur.  Rarely it is possible to have a permanent change in pigmentation.

What happens after Pearl Erbium Laser Peels?


 

After the treatment you can expect three to six days of down-time. Immediately following the procedure you may feel as if you have a bad sunburn (burning sensation). There will be redness and minor sloughing the following days. During this time you will be asked to apply a designated skincare regimen to help heal the skin quickly and reduce potential side effects. By the second day, redness will begin to fade and can usually be covered by makeup. The skin will be dry for the week after the procedure.  A post procedure skin care regimen will be recommended to assist in the healing and rejuvenation process.  

Is there another way to get the same effect?


Depending on your skin goals, other treatment options may include Photorejuvenation, Fraxel SR1500, Resurfacing treatments with CO², surgery, tissue tightening such as the Thermage® or the TitanTM, injectable fillers, BOTOX® Cosmetic , chemical peels, and microdermabrasion.

How is this different than other procedures?


The Pearl has a computer guided scanner that fixes the ideal light beam overlap for perfect coverage and uniform ablation and causes tissue coagulation immediately following ablation, allowing for the skin to have a natural protective dressing to heal itself quickly. Also, this equipment allows you to very precisely control the depth of peel you wish to create in the skin.

The first lasers available for ablative tissue removal were carbon dioxide (CO²). Although the carbon dioxide lasers were extremely effective for aging skin, incidence rates of pigmentary changes as will as scarring were a bit too frequent. The beam had a deeper area of tissue damage that went beyond the targeted area. Erbium lasers were developed to answer this difficulty. Their thermal effect is very precise; as a result this laser yields a far lower incidence of complications as well as much more rapid healing. Although carbon dioxide resurfacing is still practiced, the Erbium laser has largely replaced it in most physicians’ offices.

Can this be combined with other treatments?


We can combine this treatment with BOTOX® Cosmetic, injectable fillers such as RestylaneTM and RadiesseTM, tissue tightening procedures such as Thermage®, ReFirme STTM and TitanTM, the Pan GTM Lift, Photorejuvenation, chemical peels and medical-grade facials. All of these procedures compliment and enhance each other.

What is the cost of Pearl Erbium Laser Peels?


The fees for Erbium Pearl Laser Peels are based on the areas being treated and type of peel being performed. Please call Advanced Dermatology for a consultation and the Cosmetic Coordinator will develop a personalized treatment protocol with you.