Fractionated Erbium

Expected Results: Removal of brown/age spots and uneven pigmentation, smooth texture of the skin.

Preparation: Sun protection for several weeks prior to the treatment. Vigorous regimen of daily sunscreens and if the face is treated, night time retinoids for several months, no alcohol and aspirin for 2 weeks prior to the procedure, vitamin C 1000 mg daily starting 2 weeks prior to the treatment. There is no need for any anesthesia.

Post treatment instructions: Rigorous sun avoidance/protection for 3 months. Avoid aspirin for 10 days, continue vitamin C 1000 mg daily for 3 months. Skin care in the immediate postoperative period includes the use of a very gentle non-soap cleanser, petrolatum the night after the procedure, oral medication to prevent herpes reactivation if the face is treated. Topical retinoids can be resumed when scabbing subsides (7-10 days after treatment).

Time to desired results: 3-4 treatments, 3-4 weeks apart.

Contraindications: Recent tan, skin types that never burn (Mediterranean and some Asian skin types can be treated), isotretinoin (Accutane) in the past 6-12 months).

Duration of desired effects: Permanent with proper and vigorous sun protection of the treated areas. Future sun damage can be prevented by sun avoidance and use of a broad spectrum UVA and UVB sunscreen for life.

Downtime: Sunburn-like redness for 24-48 hours, scaling and flaking for up to 10 days. Note: Brown spots and freckles are accentuated after the treatment until skin has flaked off.