Jason Emer, MD, FAAD, FACS

Fully Ablative Erbium Laser For Severe Acne Scars What Removing The Top Layer Of Skin Actually Does

Fully Ablative Erbium Laser For Severe Acne Scars: What Removing The Top Layer Of Skin Actually Does

How Dr. Jason Emer uses tunable resurfacing laser (TRL) to treat severe rolling and boxcar acne scars by removing the top layer of skin and building new tissue in its place.

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Still from the filmed session. Individual results vary.

THE DETAIL IS THE DIFFERENCE.See the results ↓

Dr. Jason Emer MD · FAAD · FACS

MD, FAAD, FACS: board-certified dermatologist and cosmetic surgeon
Former Chief Resident in dermatology, Mount Sinai, New York
More than 10,000 patient encounters
Male facial sculpting longer than anyone in the United States
The highest filler volume on the West Coast
West Hollywood and New York

The practice's own photographs

Before. After.

Patients of the practice, from Dr. Emer's published before and after gallery. Each case is one patient. Individual results vary.

Before and after, Acne Scars Treatment, patient 240931 — Acne Scars TreatmentPatient 240931

Before and after, Acne Scars Treatment, patient 240932 — Acne Scars TreatmentPatient 240932

Before and after, Acne Scars Treatment, patient 240933 — Acne Scars TreatmentPatient 240933

Before and after, Acne Scars Treatment, patient 240934 — Acne Scars TreatmentPatient 240934

Before and after, Acne Scars Treatment, patient 240935 — Acne Scars TreatmentPatient 240935

Before and after, Acne Scars Treatment, patient 240968 — Acne Scars TreatmentPatient 240968

See the full before and after gallery

Dr. Emer removed the entire top layer of skin with fully ablative erbium laser resurfacing to treat severe rolling and boxcar acne scars that did not respond to surface treatments.

Your plan starts with Dr. Emer.

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Reserve online. West Hollywood and New York.

From the filmed session

Inside the treatment. With Dr. Emer.

ERBIUM REMOVES THE TOP LAYER OF SKIN TO GROW BRAND NEW SKIN IN SEVERE ACNE SCARS | Dr. Jason Emer

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What Dr. Emer did · RE:SKN

Every procedure. In order.

01

Fully ablative erbium laser resurfacing (TRL) RE:SKN RE:BIRTH

Tunable resurfacing laser adjusted for depth, strength and speed across each pass to remove the top layer of skin entirely, allowing new tissue to form in place of severe rolling and boxcar scars. Multiple passes at varying depths to even out scar topography and tighten loose skin.

“This is called TRL contour tunable resurfacing laser TRL. That means we can alter this in different ways for different strengths and different purposes.”
Dr. Emer, in the film
02

Micro droplet silicone STRUCTURONICS^™

Micro droplet silicone placed prior to resurfacing session to build structural foundation beneath severe scars.

“We've already done our professional and our micro drop of silicone. So, now we're doing the resurfacing part.”
Dr. Emer, in the film
03

Professional skin care protocol RE:SKN

Prescription medications, aggressive post care regimen and preventative skin care during the week-long peel and healing phase.

“You have to be on medications for this. You have to be at home while you're peeling and you have to be on aggressive skin care.”
Dr. Emer, in the film
04

Stem cells, exosomes and peptides RECODEX^™

Biologic support applied during healing to guide correct new skin formation and optimize tissue regeneration.

“That's why stem cells and exoomes and peptides help this.”
Dr. Emer, in the film

Why patients fly in

What Dr. Emer does differently.

Tunable depth and strength for each scar type

Dr. Emer adjusts the laser depth, strength and speed with every pass to match the shape and severity of rolling versus boxcar scars, evening out topography rather than applying uniform settings across the face.

“You guys can see each pass has a different purpose, different depth, different speed. So, we even everything out because this type of scar is different shaping in different areas.”

Aggressive resurfacing in darker skin when candidacy allows

He performs fully ablative resurfacing in patients with darker skin tones when prior treatment history shows tolerance and when the patient prioritizes maximum scar improvement over pigmentation risk, managing any discoloration that occurs.

“This is a little more risky as someone with a darker skin tone because of risk of hyper or hyper hypo pigmentation. However, to really get his improvement, he's not as worried about discoloration, which we can fix no matter what.”

Layered scar revision over multiple sessions

This patient had prior resurfacing, micro droplet silicone and professional skin care before this session. Dr. Emer builds results over time rather than attempting maximum correction in one treatment.

“We should be able to see a really dramatic improvement this time since it's been building upon what we've done before.”

Prescription medications and detailed post care protocols

Every patient is on prescription medications during healing, follows aggressive skin care regimens, and stays home during the peel phase. The post care is as important as the laser settings.

“The key is to be very even with the application and going to somebody that really knows how to do this and the post care for it. That's the key.”

THE THINKING BEHIND THE TREATMENT

The story.
The decisions.
The details.

Follow Dr. Emer’s approach through the stages described in this case.

Back to the video ↗

01Before
The starting point
Rolling and boxcar scars that required the strongest resurfacing option available.
This patient has severe rolling and boxcar acne scars, the kind that do not respond to surface treatments. He has already received micro droplet silicone and professional skin care, and this resurfacing session builds on that foundation.
“So in this case, he has very severe rolling and box car scars.”DR. JASON EMER · FROM THE VIDEO
02The plan
What Dr. Emer decided to do
Fully ablative resurfacing is a commitment: prescription medications, a week at home, and aggressive post care.
“And by resurfacing, it's really the only way to get it to tighten and smoothen.”DR. JASON EMER · FROM THE VIDEO
03The session
In the room, in order
Dr. Emer used fully ablative erbium laser resurfacing, adjusting the depth, strength and speed of each pass to match the shape and severity of the scar. The treatment removes the top layer of skin entirely, and new skin grows back smoother and tighter over the following week.
- Assess and map the scars
- Remove the top layer of skin
- Peel and heal at home
- Protect and maintain the new skin
04The result
What changed
This patient has a darker skin tone, which carries higher risk of pigmentation changes with ablative resurfacing. He chose to proceed because he wanted the strongest possible improvement and was not as worried about discoloration, which can be treated if it occurs. He has had this treatment before and did well with only a little bit of hyperpigmentation that Dr. Emer was able to treat.
05What comes next
Recovery and what to expect
“You have to be on medications for this. You have to be at home while you're peeling and you have to be on aggressive skin care.”DR. JASON EMER · FROM THE VIDEO

Read the complete story +

The patient story

The strongest resurfacing option for the deepest scars

The patient in this video has severe rolling and boxcar acne scars, the kind that do not respond to surface treatments. Dr. Emer is using fully ablative erbium laser resurfacing, a treatment that removes the top layer of skin entirely so new skin can grow back smoother and tighter.

This is not the first treatment this patient has had. He has already received micro droplet silicone and professional skin care, and this resurfacing session builds on that foundation. The goal is dramatic improvement, and the approach carries more risk and more commitment than lighter resurfacing.

What TRL actually does

TRL stands for tunable resurfacing laser. The word tunable means Dr. Emer can adjust the depth, strength and speed of each pass to match the shape and severity of the scar. Rolling scars need different settings than boxcar scars, and different areas of the face need different depths.

This is basically taking off the top layer of skin, which is why when it grows back patients need to be very diligent about the skin care. The laser removes damaged tissue, and the body replaces it with new collagen and new skin. That process takes a week of peeling at home, and the outcome depends on how carefully the post care is followed.

Why this treatment carries more risk for darker skin

This patient has a darker skin tone, and fully ablative resurfacing carries a higher risk of hyperpigmentation or hypopigmentation in darker skin. Dr. Emer and the patient discussed that risk before the session, and the patient chose to proceed because he wanted the strongest possible improvement and was not as worried about discoloration, which can be treated if it occurs.

This patient has had this treatment before and did well with only a little bit of hyperpigmentation that Dr. Emer was able to treat. That history gave both doctor and patient confidence to go stronger this time.

What the commitment looks like

You have to be on medications for this. You have to be at home while you are peeling and you have to be on aggressive skin care. It is a commitment and not every skin tone can do this treatment, but it is one of the best for major resurfacing of scars, sun damage and deep wrinkles.

The key is to be very even with the application and going to somebody that really knows how to do this and the post care for it. Stem cells, exosomes and peptides help the healing process, and preventative skin care is required to protect the new skin as it forms.

The treatment, explained

What is fully ablative erbium laser resurfacing?

Also called tunable resurfacing laser, TRL, erbium laser, ablative laser resurfacing, acne scar resurfacing, laser skin resurfacing.

What it is: Fully ablative erbium laser resurfacing, also called tunable resurfacing laser or TRL, removes the entire top layer of skin to treat severe acne scars, deep wrinkles and sun damage. New skin grows back over the following week, smoother and tighter than the damaged tissue it replaces. This is the strongest resurfacing option available and is designed for scars that have not responded to surface treatments.
How it works: The laser is adjusted for depth, strength and speed with each pass. Rolling scars, boxcar scars and uneven texture are mapped so each area receives the correct settings. Multiple passes remove damaged tissue layer by layer, allowing the surgeon to even out scar topography and tighten loose skin. The skin peels over the following week as new tissue forms beneath.
Who it is for: Candidates have severe rolling or boxcar acne scars, deep wrinkles or significant sun damage that has not improved with other treatments. Not every skin tone can have this treatment. Darker skin carries higher risk of hyperpigmentation or hypopigmentation, and candidacy depends on prior treatment history, scar severity and whether the patient is willing to manage pigmentation changes if they occur. Patients must be able to stay home during the peel phase and follow prescription medication and aggressive skin care protocols.
Recovery: The skin peels for approximately one week. Patients must be on prescription medications and follow detailed post care protocols during this time. Stem cells, exosomes and peptides are applied to guide correct new skin formation. Preventative skin care is required to protect the skin as it heals. The treatment plan and recovery protocols are determined at consultation based on skin type and scar severity.
When results show: New skin forms over the week following treatment, smoother and tighter than before. Many patients build results over multiple sessions rather than achieving maximum correction in one treatment. The timeline for final results is discussed at consultation.

Signature procedures

Only at Emer.

Peptides / biologic optimization

RECODEX^™

Peptide and biologic protocols for recovery, body composition and longevity, with epigenetic testing. RECODEX^™ peptides are available to purchase through the practice after consultation.

Book RECODEX^™Explore

From Dr. Emer's Instagram

The work, as he shows it.

@jasonemermd @recodexsystem

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Why Dr. Emer

Resurfacing is a science. He wrote the protocols.

Two decades of laser work, thousands of scar cases, and techniques that balance maximum improvement with controlled risk.

Dr. Emer built his reputation on outcomes that other practices could not deliver: severe acne scars smoothed, sun damage reversed, and skin that looks renewed rather than erased. He personally performs every laser treatment in his practice, and his protocols for post care and pigmentation management are studied by dermatologists internationally.

Patients come to him when the scars are deep, when other treatments have failed, and when the result has to be worth the commitment.

MD, FAAD, FACS: board-certified dermatologist and cosmetic surgeon
Former Chief Resident in dermatology, Mount Sinai, New York
More than 10,000 patient encounters
Male facial sculpting longer than anyone in the United States
The highest filler volume on the West Coast
West Hollywood and New York

About Dr. Emer Schedule Consultation

EMER METHOD^™×RECODEX^™

Depth control

Shallow scars need less depth. Deep scars need more. The laser adjusts for each area of the face.

Speed and strength

Each pass has a different purpose: evening out texture, tightening loose skin, or removing damaged tissue entirely.

Even application

The key is to be very even with the application and going to somebody that really knows how to do this and the post care for it.

Asked plainly, answered plainly

What patients ask before they commit.

What does fully ablative mean?+

Fully ablative means the laser removes the entire top layer of skin, not just the surface. New skin grows back in its place over the following week. This is different from fractional or non-ablative lasers, which leave the top layer intact.

Can darker skin tones have this treatment?+

It carries higher risk of hyperpigmentation or hypopigmentation in darker skin. Candidacy depends on scar severity, skin type, prior treatment history and whether you are willing to manage pigmentation changes if they occur. Not every skin tone can do this treatment. Dr. Emer determines candidacy during consultation.

What is the downtime?+

You must stay at home while the skin is peeling, which takes approximately one week. You will be on prescription medications and must follow aggressive skin care protocols during this time. The exact recovery plan is set at consultation based on your skin type and the treatment settings used.

How many treatments are needed?+

Many patients build results over multiple sessions rather than achieving maximum correction in one treatment. The patient in this video had prior resurfacing, micro droplet silicone and professional skin care before this session. The number of treatments needed depends on scar severity and is discussed at consultation.

What helps the healing process?+

Stem cells, exosomes and peptides are applied during healing to guide correct new skin formation. Prescription medications and preventative skin care protect the skin as it heals. The post care protocols are as important as the laser settings and are detailed at consultation.

What is the difference between TRL and other resurfacing lasers?+

TRL stands for tunable resurfacing laser, which means the depth, strength and speed can be adjusted with each pass. Dr. Emer changes the settings to match the shape and severity of each scar, evening out topography rather than applying uniform settings across the face.

What are the risks?+

Risks include hyperpigmentation, hypopigmentation, prolonged redness, infection and scarring. Darker skin tones carry higher risk of pigmentation changes. Dr. Emer manages these risks with detailed pre-treatment assessment, prescription medications and aggressive post care protocols. All risks are discussed at consultation.

Can this be combined with other treatments?+

Yes. This patient had micro droplet silicone and professional skin care before the resurfacing session. Dr. Emer often layers treatments over time to build results. The treatment plan is determined at consultation based on your scar severity and goals.

Discuss your plan

A consultation reviews your anatomy, goals and history, and maps which options apply to you.

Schedule Consultation

West Hollywood and New York City

Fully Ablative Erbium Laser For Severe Acne Scars What Removing The Top Layer Of Skin Actually Does

Before. After.

Inside the treatment. With Dr. Emer.

ERBIUM REMOVES THE TOP LAYER OF SKIN TO GROW BRAND NEW SKIN IN SEVERE ACNE SCARS | Dr. Jason Emer

Every procedure. In order.

Fully ablative erbium laser resurfacing (TRL) RE:SKN RE:BIRTH

Micro droplet silicone STRUCTURONICS™

Professional skin care protocol RE:SKN

Stem cells, exosomes and peptides RECODEX™

What Dr. Emer does differently.

Tunable depth and strength for each scar type

Aggressive resurfacing in darker skin when candidacy allows

Layered scar revision over multiple sessions

Prescription medications and detailed post care protocols

The story.The decisions.The details.

The starting point

What Dr. Emer decided to do

In the room, in order

What changed

Recovery and what to expect