Full-Field Ablative Laser Resurfacing
Continuous full-surface ablation for advanced wrinkles, photodamage, and scars
이 치료에 대해
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.
작용 기전
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.
적응증
기대 효과
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.
임상 근거
위험 및 부작용
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.