Laser Resurfacing

Erbium Laser Resurfacing

Target pigmentation, moderate to deep wrinkles, and uneven tone and texture with powerful ablative technology

Surgery often comes to mind first for people interested in facial rejuvenation. While there is no doubt procedures like a face and neck lift, brow lift or blepharoplasty can transform the face, many patients neglect to consider the skin itself.

We like to think of the skin as the canvas on which the painting, or piece of art, is produced. If the canvas looks aged, it contributes significantly to creating the overall impression of an aged appearance. This is true whether you have yet to explore cosmetic medicine or whether you are a veteran of aesthetic treatments.

Dr. Burns is a renowned expert in the field of laser treatments in Dallas, TX. Since the introduction of lasers into aesthetic medicine, Dr. Burns has played key roles in bringing new devices to market and advancing their use. He has as much experience as anyone in the world in advanced laser resurfacing and has chosen to offer the Erbium laser at Resurrect Skin MD for patients seeking deeper laser resurfacing. He is widely published on the topic, travels regularly for speaking engagements and teaches his techniques and perspectives to colleagues through sold-out preceptorships hosted regularly at RSMD in Dallas.

laser resurfacing dallas

Treatment Time

30-60 min




Varies (ypically 7-10 days of healing followed by several weeks of decreasing redness)

Full Results

3-6 months

Treatments Needed


What Is Erbium Laser Resurfacing?

Today’s patients have access to many types of laser procedures, from milder forms of treatment that rejuvenate the skin by generating collagen to more aggressive resurfacing procedures performed under anesthesia.

Erbium laser resurfacing stands at the pinnacle of effectiveness but should only be used for moderate to deep wrinkles and advanced sun damage. As an ablative technique, the Erbium laser literally removes the old and damaged upper layers of skin. The vaporization occurs immediately upon contact with the laser.

A secondary benefit of the procedure is activating collagen and elastin production to improve skin structure, which takes up to 6 months to complete. This deposition can often be the difference between a good and a great result, but the amount of new collagen deposited depends on the patient’s immune system and cannot be controlled by the patient or Dr. Burns.

Erbium has replaced CO2 laser resurfacing, which was popular in the late 90s. Although CO2 resurfacing procedure is effective, it has a much higher complication rate and a longer, more intense recovery. It is also suitable for a narrower range of people. The Erbium laser offers excellent results with greater convenience and comfort than CO2 laser resurfacing.

What Are the Four Pillars of Aging?

In other sections of this website, you will find detailed explanations of the four pillars of aging (gravity, dynamic lines, skin and volume), but suffice it to say that a holistic global approach addressing all four causes of aging produces the most natural look. We desire a natural look for our patients just like they do.

It may seem counterintuitive, but addressing all of the signs of aging is not “aggressive,” but rather, “thorough” — it is usually prudent to achieve a more natural look in which the “skin age” matches the “volume age,” which matches the “gravity age,” and so on. Making a 70-year-old facelift patient’s face look 50 and leaving the skin still looking 70 creates an unnatural appearance that has nothing to do with the quality of the surgery but is a result of neglecting the aging skin.

On the other hand, if you want to address only one of the four pillars of aging in isolation, it is Dr. Burns’ opinion that the pillar that makes the most difference is ensuring the skin looks as young as possible. In patients with advanced sun damage and wrinkling, Dr Burns believes strongly that Erbium laser skin resurfacing offers the most optimal correction. Less aggressive measures may help to some extent but only with color and fine lines, not the deep wrinkles and advanced texture abnormalities seen with significant sun damage.

laser skin resurfacing dallas

What Are the Benefits of the Erbium Laser Treatment?

Some of the benefits of this technology include:

  • Versatile applications that can treat either superficially or very deep
  • Anesthesia options that do not necessarily require general anesthesia in every case
  • Fewer side effects and less downtime than CO2 laser resurfacing (Dr. Burns published these findings along with his technique in January 2019 in the prestigious journal of Plastic and Reconstructive Surgery)
  • Achieves more significant results than nonablative fractional laser treatments and all other lasers used to treat wrinkles
  • Gold standard treatment for deep wrinkles on the face, including lip lines that are tough to treat

“CO2 lasers were considered the gold standard for skin resurfacing in the 1980s and 1990s, and I used them extensively and published on the topic. It was a good treatment for its time, but it has fallen out of favor due to its side effects and higher complication rate. Today, I prefer Erbium lasers for ablative resurfacing because they offer powerful results with fewer risks and side effects and shorter downtime.”

— Dr. Burns
laser resurfacing

What Can Erbium Laser Resurfacing Do?

Ablative laser technology is capable of addressing a wide range of concerns, including some that are beyond the scope of superficial technologies.

  • Mild, moderate and deep wrinkles
  • Almost complete correction of age spots and sun spots (most brown pigmentation)
  • Acne scarring
  • Surgical and trauma scars
  • Dull complexion
  • Uneven skin tone

The Erbium is a more invasive, aggressive laser than others used for skin rejuvenation. To emphasize the intensity of this treatment, we sometimes categorize it with our surgical procedures even though it is not technically surgery. We hope this helps you prepare for the downtime as well as the substantial results you can achieve.

Dr. Burns specializes in performing deep Erbium resurfacing treatments that can dramatically transform the skin without compromising on patient safety.

Am I a Good Candidate for the Erbium Laser?

Laser treatments can be done at any age, but the Erbium laser isn’t for everyone. Because it is a more aggressive procedure than some of our other options, it is best for individuals who have more advanced concerns and who want to avoid needing an extended series of treatments to reach their goals. It is especially well-suited for treating perioral rhytids, the vertical lines that develop around the lips (also known as “smoker’s lines” or “lipstick lines”).

Erbium laser skin resurfacing is safer for darker skin tones than some alternatives, but caution is still advised. There is a risk of hypo/hyperpigmentation post-treatment in Fitzpatrick types IV to VI (ethnic or darker skin types).

During a one-on-one consultation, an RSMD provider will thoroughly assess your medical history, skin condition and desired outcomes to determine which resurfacing method is best for you. The good news is that no matter what your issue is, RSMD has the complete gamut of state-of-the-art equipment and lasers to treat any of your needs.

What Should I Expect During My Treatment?

Before treatment begins, your RSMD provider will cleanse your skin and administer the anesthesia of your choice.

The comfort level of Erbium laser resurfacing varies from patient to patient and depends primarily on the depth of treatment required and the area treated, which varies from patient to patient. The procedure is often tolerated with topical and/or injected local anesthetic if treatment is limited to the mouth area. However, deeper, full-face treatments usually require general anesthesia and are preferred by most patients.

To perform the treatment, Dr. Burns will pass the laser handpiece over your skin. Some areas may require more than one pass to maximize results. A full-face treatment usually takes 30 to 45 minutes.

What Is the Recovery Like After Erbium Laser Resurfacing?

Downtime is expected with laser resurfacing procedures. It is important to follow instructions during this time, as your skin will be sensitive and require extra care. It is especially critical to avoid too much exposure to ultraviolet light/sunlight until fully healed. Stay out of the sun as much as possible, and if you cannot avoid being outdoors, wear a hat and sunscreen on the healed areas.

Keeping your skin moist and clean are the two key elements of your post-procedure care. You will apply the ointment prescribed by Dr. Burns and our staff. It should be applied liberally after cleansing. There is a specific but simple and effective regimen that will be detailed to you for both preoperatively and postoperatively.

Some swelling is common the first few days after laser resurfacing, as is a sensation of heat for the first 24-48 hours. We apply an advanced cool collagen face mask that is soothing to minimize the heat sensation during this time period. It may look and feel like you have a sunburn during the initial wound healing stage, which lasts approximately 7-10 days. For the first few days you will have an open wound that oozes that you must keep clean and moist, as stated above. Following this period, residual redness fades over the next few weeks.

Please note that redness is not a bad thing. In this situation, it is a sign of “construction” that occurs because of new red blood vessels delivering a new layer of collagen and elastin. It indicates overall healing. The top layer of your skin will regenerate in about one week. This is when you can resume using sunscreen and cosmetics, and consequently, it is also when most patients feel comfortable resuming social interactions with makeup.

What Are the Expected Results With Erbium Laser Resurfacing?

The results of an ablative Erbium laser treatment will be apparent relatively quickly, as many of the wrinkles are significantly reduced or even eliminated during the procedure. However, the new collagen and elastin are laid down over the next six months, and these results will emerge gradually as your skin heels and post-treatment redness and swelling resolve.

Patients typically only need one Erbium laser treatment to achieve their goals and enjoy their results for years. If any lines are left, they are usually minimal, but we have other techniques that can be utilized to minimize these few remaining lines if desired. Fortunately, that is an unusual request for most of our patients, as they are satisfied with the LRS alone.

“Laser technology has benefited from a number of breakthroughs in the last few decades. There are ablative and nonablative lasers, as well as fractional and non-fractional technology, and now there are other lasers like HALO, the world’s first hybrid fractional laser, and BBL HERO and MOXI. At RSMD, we offer a variety of laser technologies to ensure our patients’ needs are met.”

— Dr. Burns

Contact RSMD for Laser Skin Resurfacing in Dallas, TX

Dr. Burns is proud to offer a handpicked selection of sophisticated laser treatments at Resurrect Skin MD. As an expert in laser resurfacing and rejuvenation, his office is equipped with the latest technology available and an expertly trained staff who are among the best in their respective fields.

We look forward to welcoming you soon at our beautiful and friendly clinic. In the meantime, if you have any questions about the Erbium laser or would like to book a consultation, please call us at 219-754-6865 or submit our contact form.