Full-Field Ablative Laser Resurfacing
Continuous full-surface ablation for advanced wrinkles, photodamage, and scars
About This Treatment
Full-field ablative resurfacing uses 10,600-nm CO₂ or 2,940-nm Er:YAG energy to continuously vaporize the epidermis and a controlled portion of superficial dermis across the treatment field. Unlike fractional resurfacing, it does not intentionally preserve microscopic columns of untreated skin. This allows substantial change from a single procedure for deep rhytides, advanced photodamage, coarse texture, and selected atrophic scars.
The tradeoff is open-wound-style aftercare, infection prevention, strict photoprotection, and potentially prolonged erythema. CO₂ generally creates more residual thermal coagulation and remodeling, whereas Er:YAG tends to leave less residual thermal injury. Actual depth, efficacy, and safety depend on mode, fluence, number of passes, anatomy, skin type, and operator experience.
Mechanism of Action
Both CO₂ and Er:YAG primarily target tissue water to vaporize epidermis and controlled superficial dermis. CO₂ creates a comparatively broader coagulation zone, supporting hemostasis, immediate collagen contraction, and wound-healing-driven neocollagenesis. Er:YAG is absorbed more strongly by water and produces less thermal diffusion, allowing precise layer-by-layer ablation and generally faster re-epithelialization. With no intentional untreated epidermal columns, healing proceeds from follicular and sebaceous adnexa and the treatment margins, followed by months of dermal remodeling.
Indications
Expected Results
Re-epithelialization generally progresses over 7-14 days after one treatment, while wrinkles, roughness, dyschromia, and scar appearance continue to evolve as erythema settles over weeks to months. Collagen and elastic-tissue remodeling can continue for at least 3-6 months. Comparative literature generally favors CO₂ for stronger wrinkle improvement and Er:YAG for a more favorable recovery and complication profile, although studies and parameters are heterogeneous.
Clinical Evidence
Risks & Side Effects
Substantial pain, swelling, oozing, crusting, approximately 7-14 days of wound care, and erythema lasting weeks to months can occur. Risks include HSV reactivation, bacterial or fungal infection, milia, acneiform eruption, post-inflammatory hyperpigmentation, prolonged hypopigmentation, demarcation lines, scarring, and rare periocular ectropion or ocular injury. Fitzpatrick III-VI skin, recent tanning, keloid tendency, and impaired wound healing require especially careful selection.
Interested in this treatment?
Start with an AI skin analysis to check your current skin condition