Skip to content
Choose division
DermatologyAesthetics
DEEN
Dr. NüchelAesthetics
Book
Erbium:YAG laser at Dr. Nüchel Aesthetik in Mönchengladbach

Laser treatments

Erbium:YAG laser

Gentle and precise removal of age spots, age warts and fine lines – with the Erbium:YAG laser and usually a short downtime.

Treatable areas

  • Face
  • Seborrhoeic warts
  • Hands
  • Forehead & eye area
  • Mouth area
  • Décolleté

The Erbium:YAG laser works with a wavelength of 2,940 nanometres, which is absorbed particularly strongly by water in the skin. Superficial skin layers can thus be removed very precisely and in a controlled manner (skin resurfacing), while the spread of heat into the surrounding tissue remains low – the skin usually regenerates quickly, and the downtime is generally shorter than with the CO2 laser. For this we use an Erbium:YAG laser system by Asclepion.

Typical areas of application are age spots (lentigines), age warts (seborrhoeic keratoses), small benign skin changes such as fibromas, and fine lines around the eyes or mouth. Before every laser treatment comes the medical assessment of whether the skin change really is benign.

All information is provided for general guidance and does not replace personal medical advice. Treatment results can vary from one individual to another.

Indications

Who it is suitable for

Whether a treatment makes medical sense in your case is something we determine together in a personal consultation. Typical concerns include:

  • Age spots (lentigines) on the face, hands or décolleté
  • Age warts (seborrhoeic keratoses) after prior dermatological assessment
  • Small benign skin changes such as fibromas (soft connective-tissue nodules)
  • Fine lines, for example around the eyes and mouth
  • Unevenness of the skin surface and individual superficial scars
  • A wish for a finer, more even skin appearance through superficial skin resurfacing
  • Patients who prefer the shortest possible downtime

Step by step

How the treatment works

This is how the treatment usually proceeds with us – from the first consultation through to aftercare.

  1. Medical consultation and skin assessment

    We examine the skin changes, where appropriate with the dermatoscope (epiluminescence microscope), and ensure that they are benign findings suitable for the laser. We then discuss the approach, realistic expectations, alternatives as well as risks and side effects.

  2. Preparation and anaesthesia

    The skin is cleansed and disinfected; depending on the area, an anaesthetic cream takes effect over about 30–45 minutes or we use a local anaesthetic – very small changes can often be treated well without. Special goggles protect your eyes.

  3. Laser treatment

    We remove the skin change layer by layer; the depth of removal can be controlled precisely and the surrounding tissue is largely spared. The laser treatment itself usually takes a few minutes up to about half an hour, depending on the number and size of the areas.

  4. Direct after-treatment in the practice

    Immediately afterwards we cool the treated areas and apply a nourishing wound ointment; the skin may be reddened and sting slightly, similar to after sunburn. You receive concrete recommendations for care at home.

  5. Check-up and, if needed, follow-up sessions

    Individual age spots, age warts or fibromas can often be removed in one session; extensive areas or fine lines are treated step by step over several sessions at intervals of a few weeks. If needed, we arrange a check-up appointment.

Transparency

Prices

1–3 Stellen
150 €
Jede weitere Stelle
30 €

All prices are guide values for initial orientation. Medical services are billed according to the German scale of fees for physicians (GOÄ); the final amount depends on the individual effort involved and is discussed transparently with you before treatment. For treatments without a listed price, we are happy to give you a guide value during your consultation.

Enquire about this treatmentView the full price list →

Patient information

Safety & patient information

Responsible treatment includes open information about possible risks and side effects – even when they occur only rarely.

  • Redness, swelling and stinging

    Immediately after the treatment, the skin is reddened, slightly swollen and may sting or feel tight. These reactions usually subside within a few days; slight redness may persist somewhat longer.

  • Crust formation and weeping

    Fine crusts form on the removed areas, which may weep slightly at first. The crusts usually fall off by themselves after about five to ten days; scratching them off prematurely increases the risk of scars and pigment disturbances.

  • Temporary pigment shifts

    The treated skin may appear temporarily darker (hyperpigmentation) or lighter (hypopigmentation) after healing – more frequently with sun exposure during the healing phase and in darker skin types. The shifts usually recede over weeks to months.

  • Persistent pigment disturbances

    In rarer cases, pigment shifts persist permanently; a persistent loss of pigment (hypopigmentation) in particular cannot always be fully corrected.

  • Delayed wound healing and lingering redness

    Healing can, in individual cases, proceed more slowly than expected, and a visible redness (erythema) may persist over several weeks. Certain pre-existing conditions, smoking and a lack of aftercare can impair healing.

  • Infections

    As the laser creates a superficial wound, there is a risk of infection by bacteria or viruses. In the case of a known tendency to cold sores (herpes simplex), the procedure can trigger a renewed outbreak; a preventive medication prophylaxis can then be sensible. Careful wound care lowers the risk.

  • Scar formation

    Visible scars are rare with professional, superficial treatment, but cannot be completely ruled out. The risk is increased with removal that is too deep, disturbed wound healing, infections or a tendency to excessive scar formation (hypertrophic scars, keloids).

  • Incomplete removal or recurrence

    Not every change can be completely removed in one session; in some cases follow-up sessions are necessary. Age spots can reappear with renewed sun exposure.

  • Deviating or absent result

    The aesthetic result varies from person to person and may deviate from expectations; particularly with resurfacing of fine lines, the effect is usually subtle due to the low thermal depth effect. A particular result cannot be guaranteed.

  • Reactions to anaesthesia and positioning

    With local anaesthesia, intolerances or allergic reactions to the anaesthetic are possible – very rarely. Please inform us of relevant pre-existing conditions and allergies before the treatment.

When we do not treat

In certain situations we do not carry out a treatment, or only at a later time – for your safety.

  • Skin changes whose benign nature is not established beyond doubt – these must first be clarified dermatologically and, where appropriate, histologically.
  • Pregnancy and breastfeeding – we refrain from aesthetically motivated laser treatments during this time, as there are insufficient safety data.
  • Acute skin infections, open wounds or inflammatory skin conditions in the treatment area (e.g. an acute cold-sore outbreak or a bacterial skin infection).
  • Fresh tanning or strongly sun-damaged skin in the treatment area – increased risk of pigment shifts; the treatment should be postponed.
  • A known tendency to excessive scar formation (hypertrophic scars, keloids) – here particular caution is called for.
  • Certain medications that increase the skin's light sensitivity or impair wound healing, as well as acne therapy with high-dose vitamin-A-acid derivatives (isotretinoin) in the past months – the approach is weighed up individually by a physician.
  • Coagulation disorders or anticoagulant medications – these are medically assessed before the treatment; stopping them on one's own initiative is to be avoided without fail.
  • Severe general illnesses, a pronounced immune deficiency or other factors that considerably disturb wound healing.
  • Unrealistic expectations or a lack of willingness for consistent aftercare and UV protection.

This information does not replace a personal medical consultation. Before every treatment we inform you individually about the procedure, risks and alternatives.

In depth

Medical details & background

How it works & the evidence

The Erbium:YAG laser is an ablative laser, that is, one that removes tissue. Its erbium-doped yttrium-aluminium-garnet crystal emits light almost exactly at the absorption maximum of water, which absorbs this energy about ten times more strongly than that of the CO2 laser (10,600 nanometres). The energy is therefore absorbed already within a very thin layer of tissue and vaporises the tissue water abruptly ('cold' ablation): heat is produced, but only very little of it reaches deeper layers – the residual thermal damage is considerably lower than with the CO2 laser.

Two things follow from this: the depth of removal can be dosed finely and in a controlled manner, and the skin usually heals more quickly (faster re-epithelialisation) – hence the typically shorter downtime. The downside: the tightening and collagen-stimulation effect is usually weaker than with the CO2 laser due to the lower heat effect; if the primary concern is a marked tightening of deeper wrinkles, another procedure may be better suited. Modern devices compensate for this in part through variable pulse durations.

As the laser removes the tissue, a finding can no longer be examined fully histologically afterwards. It must therefore be clarified beyond doubt before the treatment that a benign change is present; in the case of unclear or suspicious findings, a tissue sample is first taken and examined, or a different approach is chosen.

Ablative laser therapy with the Erbium:YAG laser has for many years been an established procedure in dermatological and aesthetic medicine. Controlled studies and systematic reviews describe, for superficial skin resurfacing and the removal of benign changes such as lentigines and seborrhoeic keratoses, overall favourable results with – compared with the CO2 laser – usually lower thermal burden and shorter healing time; the underlying physical mechanisms of action are well understood.

Caution nevertheless remains appropriate: many studies have small case numbers, differing protocols and partly subjective evaluation criteria; statements about long-term results are only of limited robustness. Treatment results vary from person to person – skin type, the type and depth of the change, sun behaviour and aftercare influence the result – and cannot be guaranteed.

Preparing for your treatment

A few simple measures before your appointment help you contribute to the best possible result with as few complications as possible.

  • Sun abstinence: In the weeks before the treatment, avoid intense sunlight and tanning beds in the treatment area; freshly tanned skin should subside before the procedure.
  • Medications: Inform us of all medications – in particular anticoagulants and photosensitising preparations. Never stop anticoagulants on your own initiative, but only after medical consultation.
  • Skin condition: The area should be free of acute inflammation, infections and irritation on the day of treatment. In the case of a tendency to cold sores, inform us in advance so that a preventive treatment can be considered.
  • Care and cosmetics: On the day of treatment, no make-up, creams, self-tanner or irritating care products (e.g. fruit acids, vitamin-A acid) in the treatment area.
  • Pre-existing conditions and allergies: Tell us about relevant pre-existing conditions, allergies (including to anaesthetics) as well as previous problems with wound healing or scarring.
  • Planning: Expect a few days of redness and crust formation afterwards; better not to place important social engagements immediately after the treatment.
Aftercare

The right care after treatment supports healing and the result. You will receive individual recommendations from us – as a rule:

  • Cooling: In the first few hours you can carefully cool the treated areas – no ice cubes directly on the skin.
  • Wound care: Apply the recommended ointment according to the instructions and keep the area clean. Under no circumstances scratch off the crusts – they fall off by themselves after a few days.
  • UV protection: Avoid direct sunlight for several weeks and, as soon as the skin permits, use sun protection with a high sun protection factor (SPF 50+) – the most important protection against pigment shifts.
  • Sport, sauna, swimming pool: In the first few days, refrain from intensive sport, heavy sweating, sauna, steam bath and swimming pool; light activity is usually possible again after a few days, more intensive exertion after about a week.
  • Cleansing and cosmetics: Cleanse the area only gently; make-up and irritating care products only after healing and in consultation with us.
  • No mechanical irritation: Avoid rubbing, peels and tight, chafing clothing in the treatment area until the skin has fully healed.
  • Watch for warning signs: In the case of increasing redness, severe swelling, pain, pus formation or fever, please contact us – these can be signs of an infection.
  • Follow-up monitoring: Attend the agreed check-up appointments so that the result can be assessed.

FAQ

Frequently asked questions

Answers to questions we are asked particularly often about “Erbium:YAG laser”.

Most patients find it well tolerable; the laser pulses feel like a fine tingling or a brief stinging. Depending on the area, an anaesthetic cream or a local anaesthetic ensures a largely low-pain course. Afterwards the skin may sting for a few hours.

Both lasers remove skin tissue. The Erbium:YAG laser gives off hardly any heat into the depth and is particularly suited to precise, gentle removal of superficial changes – usually with a shorter downtime. The CO2 laser generates more heat in the tissue – an advantage for deeper wrinkles, but usually with a longer healing phase.

Assessment of the skin changes and the laser treatment are carried out by licensed physicians with a dermatological background. In any case of doubt about the benign nature of a finding, we carry out a histological clarification (histology) before removal, or refer accordingly.

There is no fixed age limit – the findings are decisive, not age. In minors, we do not, as a matter of principle, carry out aesthetically motivated procedures; medically justified findings are assessed in the individual case and with the consent of those with custody.

A treatment is possible all year round; autumn and winter are, however, often considered more favourable due to the lower sun intensity. In summer, reliable sun protection and avoiding direct sunlight are particularly important.

Sources & guidelines

  • AWMF guideline register (Association of the Scientific Medical Societies) – guidelines on skin tumours and dermatological procedures as orientation for the indication and clarification of skin changes.
  • German Dermatological Society (DDG) – professional recommendations and information on dermatological laser and skin treatments.
  • Prescribing information and manufacturer-independent application recommendations on medical laser systems as well as published controlled studies and systematic reviews on ablative laser therapy.
  • Note: These general source references serve as orientation and do not replace the personal medical consultation.

Personal consultation

Arrange a personal consultation

In a confidential conversation on our practice floor at the Albertus Zentrum in Mönchengladbach, we take time for your questions and assess whether the treatment may be suitable for you.

Book a consultation

More treatments

You might also be interested in

For deeper wrinkles or a wish for more pronounced tightening, the fractional CO₂ laser may be more suitable; for pigmented changes and tattoos, Q-switched lasers (pico or Nd:YAG laser); for vascular changes, the dye laser. For concerns beyond the skin surface – volume, facial expression, contour – botulinum toxin, hyaluronic acid fillers, injection lipolysis or medically supervised weight management come into question.

Erbium:YAG laserBook now