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Erbium and Co2 Laser Resurfacing in the Bay Area

Erbium & Co2 Laser – Ablative Laser Therapies

Laser Resurfacing

Using ablative laser therapies, including erbium and Co2 lasers, For The Face – Lieberman & Parikh Facial Plastic Surgery,  can treat patients in the Bay Area who have aging, sun-damaged and / or blemished skin.

While erbium and Co2 are designed for different conditions, both lasers work by sending brief pulses of high-energy light into the skin to vaporize damaged skin cells. The laser energy also stimulates the underlying layers of skin which encourages the body’s own natural collagen production. As the lasered skin heals, new skin that is smoother, tighter and more healthy is encouraged to form in its place.

  • Find out more about erbium and Co2 laser treatments in the San Francisco Bay Area and what it can do for your face. Request your consultation online or call 650-327-3232 to schedule an appointment in our Palo Alto or San Jose office.

Laser treatments can leave patients with more natural-looking skin by improving such imperfections* as:

  • Wrinkles
  • Sun damage
  • Crow’s feet
  • Brown spots
  • Blotchiness
  • Acne
  • Chicken pox scars
  • Superficial facial scars

*Individual results may vary.

How Are Laser Procedures Performed?

Laser procedures are performed on an outpatient basis using a local anesthetic to help mitigate any potential pain. Usually our nursing staff administers erbium laser treatments while Drs. Lieberman and Parikh treat more severe cases with the Carbon Dioxide Laser (Co2).


During both treatments, your provider will pass the laser over the targeted area several times until the skin’s imperfections are less visible and only a smooth layer of skin remains. There is never any bleeding. Depending on the size and condition of the area being treated, your erbium or Co2 treatment will last between 30 minutes to two hours. Some patients will need multiple treatments to achieve their desired results but others will find the desired results after only one treatment.

  • Learn more about an erbium or Co2 laser therapy in San Francisco, available at For the Face – Lieberman & Parikh Facial Plastic Surgery. Call 650-327-3232 or emailto set up a consultation.

What is The Difference Between Erbium & Co2?

Erbium and Co2 lasers are both ablative lasers which simply means that they are designed to remove the outer layers of skin to reveal smoother, tighter and more healthy layers of skin*. The main difference is in the two therapies is the depth and intensity of treatment – erbium is less invasive while Co2 is stronger and throws heat into the deeper layers of skin to treat deeper imperfections, including deep wrinkles.

What You Need To Know About the Erbium Laser

Who Is a Good Candidate for the Erbium Laser?

Anyone looking to improve skin texture, treat shallow wrinkles around the eyes, mouth or forehead or enhance non-responsive skin after a facelift, may consider erbium. Erbium is good for all skin types, including darker tones while IPL and Co2 are not. While erbium does not produce as dramatic results as Co2 laser does*, there are many advantages to erbium:

  • Less downtime after erbium
  • Some say that erbium is not as painful as Co2
  • Younger patients, who need only a gentle resurfacing, will usually see results with erbium*
  • Erbium can treat small patches of skin while Co2 must be done on the entire face or other large area.
  • Erbium can treat thin, delicate areas like around the eyes and upper lips.

At For The Face – Lieberman & Parikh Facial Plastic Surgery, we use the erbium Yag 2940, a state-of-the-art laser which was designed to treat the following:

  • Superficial wrinkles around the mouth, eyes, cheeks and crow’s feet
  • Rough skin
  • Enlarged pores
  • Some scars
  • Dark spots, including melasma

What You Need To Know About the Co2 Laser

Who is a Good Candidate for Co2?

Carbon dioxide (CO2) laser resurfacing is the gold-standard in laser skin resurfacing and can produce dramatic results that take up to 20 years off the way a patient looks. Anyone with a lighter skin tone, looking to improve deep wrinkles or stubborn blemishes across the entire face should consider the Co2 laser. However, Co2 is not appropriate for people with darker skin tones because there is a 15% chance of permanent skin lightening. For people with lighter skin tones, Co2 produces dramatic results by treating*:

  • Deep lines & wrinkles
  • Sunspots and age spots
  • Skin texture irregularities
  • Acne and scars
  • Photodamaged skin
  • Enlarged pores

How Do Lasers Compare to Chemical Peels and Micro-Penning?

Due to their strength, laser procedures usually more dramatic results than both chemical peels and micro-penning. However, with laser resurfacing, there is usually more downtime than with the other two treatments.

Are Laser Treatments Painful?

Laser Treat

Pain tolerance varies from person to person, and the level of discomfort will vary by the location and depth of the treatment. On a scale from 0-10, (0 being no pain, and 10 being unbearable pain), our patients usually report a 3-5 level of discomfort. For erbium treatments, a topical anesthesia will be applied 30 minutes prior to treatment, and for CO2, Drs. Lieberman and Parikh will offer patients a local nerve block though an oral analgesic.

Erbium & Co2 Post-Treatment & Recovery Process

What Is The Recovery After Erbium and Co2 Treatments?

For approximately 3-5 days after an erbium treatment, and anywhere from 10 days to four weeks after CO2 treatment, your skin will look like it has been severely sunburned. During this time, it may feel raw and have some oozing drainage. Some patients report a tingling, burning or itching sensation that comes and goes throughout the day.

Once your skin has begun to heal, the outer layers will peel off and new, healthy skin will grow in its place. Your skin might remain pink or red for up to two months after the treatment, but most patients are able to cover-up the discoloration with makeup.

Our staff will instruct you on how to care for your skin during the healing process, and you may use ice or pain medication to alleviate any discomfort, but it is critical to stay out of the sun as too much sun could cause permanent, irregular discoloration.

Are There Any Risks Associated with Laser Treatments?

There are minor risks associated with lasers, but negative side-effects are very rare, especially in our office where our practitioners are highly trained. Possible side-effects can include scarring, infection, abnormal healing and allergic reactions, all of which our staff will discuss with you prior to your appointment.

Also, we generally recommend that people with darker skin tones do not get Co2 laser skin resurfacing because of the strength of the laser and slight risk of permanent skin lightening.

Pre-Procedure Prep for Erbium and CO2 Laser Treatments

Before any laser treatment, you will have a consultation with either Dr. Lieberman or Parikh, and before any treatment, our staff will provide you with personalized and detailed instructions on how to prepare. Below, you will see the general guidelines:

4-6 weeks prior:

  • Begin using a retinol, vitamin A cream, alpha-hydroxy acid or a hydroquinone cream.

2 weeks prior:

  • Stop using the retinol, vitamin A cream, alpha-hydroxy acid or a hydroquinone cream.
  • Stop using aspirin (if medically possible). Tylenol (acetaminophen) is fine.
  • To avoid bruising, stop taking vitamin E, St. John’s Wort, ginkgo biloba, evening primrose, garlic, feverfew, and ginseng to avoid bruising. Tylenol (acetaminophen) is fine.

2 days prior:

  • Do not use medications that cause photosensitivity such as doxycycline or minocycline.
  • Stop taking ibuprofen and drinking alcohol.
  • Hydrate as much as possible. The laser is attracted to the water in your cells so your results will be better if you are well hydrated.
  • If you are prone to cold sores, begin an antiviral and continue for 3-5 days after treatment.

Post-Procedure for Lasers

After your laser treatment, we recommend the following:

  • Get lots of rest with your head and shoulders elevated to help minimize the swelling that may occur around the eyes and cheeks.
  • Apply Aquaphor to the area immediately after treatment but then keep the area dry so the peeling with begin sooner.
  • Avoid activities that can cause flushing for two weeks after treatment.
  • Avoid aggressive facial treatments, such as microdermabrasion and chemical peels, for 4 weeks post treatment and avoid topical products that may cause irritation for 6 weeks following your treatment.
  • Be aware that acne lesions or milia (white-colored tiny keratin plugs) can occur up to a month after treatment.
  • Contact our office if you develop acne or milia or if blistering, crusting, or scabbing develops. We will most likely recommend a thin layer of antibiotic ointment (such as bacitracin) for you to use twice a day until the skin heals. Do not pick or attempt to remove scabs that form following your treatment, as this may cause infection or scarring.
  • If you are interested in learning more about which laser treatment is right for you, please call For the Face at 650-327-3232 or email our staff to set-up a consultation with one of our qualified medical staff members.