Jason Emer, MD, FAAD, FACS

Deep Laser Resurfacing On Darker Skin How Dr. Emer Uses Erbium Without Hyperpigmentation

Deep Laser Resurfacing On Darker Skin: How Dr. Emer Uses Erbium Without Hyperpigmentation

The rebirth procedure combines deep fractional erbium with surface resurfacing and immediate plasma aftercare, designed to work on all skin tones when the protocol is followed exactly.

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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, Laser Skin Resurfacing, patient 253641 — Laser Skin ResurfacingPatient 253641

Before and after, Laser Dermatology, patient 241532 — Laser DermatologyPatient 241532

Before and after, Acne Scars Treatment, patient 240815 — Acne Scars TreatmentPatient 240815

Before and after, Acne Scars Treatment, patient 240904 — Acne Scars TreatmentPatient 240904

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

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

See the full before and after gallery

Dr. Emer performs deep erbium laser resurfacing on ethnic skin tones using fractional and surface erbium with immediate plasma and cooling aftercare, a protocol designed to prevent the hyperpigmentation that makes other practices refuse the treatment.

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From the filmed session

Inside the treatment. With Dr. Emer.

| Dr. Jason Emer

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What Dr. Emer did · RE:SKN

Every procedure. In order.

01

Deep fractional erbium laser RE:SKN RE:BIRTH

ProFractional erbium creates deep channels through the dermis to release blood and remove scar tissue; erbium runs colder than CO2, critical for darker skin; cheeks where scars were worst received the deepest settings.

“So all the blood is coming up through little channels. You want the blood, it actually helps the healing process.”
Dr. Emer, in the film
02

Surface erbium resurfacing RE:SKN RE:BIRTH

TRL Contour erbium resurfaces the entire top layer, feathered into the hairline and jaw to eliminate visible cut-off lines; every spot covered meticulously to prevent uneven healing.

“Every spot needs to be meticulously done with this laser. Otherwise, you could risk causing little lines or cut offs.”
Dr. Emer, in the film
03

Bio rain plasma application RE:SKN RE:BIRTH

Patient's own blood plasma mixed with exosomes, stem cells and PDRN applied immediately while skin is bleeding; clots the blood, starts repair before inflammation sets in.

“All the areas we've processed is now mixing with the live blood and we find this makes them heal a lot faster.”
Dr. Emer, in the film
04

Glacial cooling device RE:SKN RE:BIRTH

Cooling device applied after plasma to bring skin temperature down, reduce pain and prevent the heat that triggers pigment changes in darker skin.

“We want to cool him down so that we can get him ready for healing and it make it substantial without a lot of pain.”
Dr. Emer, in the film

Why patients fly in

What Dr. Emer does differently.

Erbium on ethnic skin when others refuse

Dr. Emer uses erbium laser on darker skin tones with the right prep, settings and aftercare; erbium runs colder than CO2, making it safer for ethnic skin when the protocol is followed exactly.

“This is an herbium laser which is a little bit colder than CO2. So, it can be used on all different skin types.”

Immediate plasma aftercare prevents hyperpigmentation

Bio rain (patient's own plasma with exosomes, stem cells, PDRN) is applied while the skin is still bleeding, clotting the blood and starting repair before inflammation can cause pigment changes.

“If he did this laser and did not do a lot of this afterare, there's a very high chance he could get hyperpigmentation or not heal well.”

Depth adjusted by zone, feathered to prevent lines

Deepest settings on the cheeks where scars were worst, lighter on the rest of the face, feathered into hairline and jaw so there are no visible cut-offs when healed.

“We're making sure we blend into the hairline and along the jaw. This is called feathering.”

Cooling device completes the protocol

Glacial cooling applied immediately after plasma to bring skin temperature down, reduce pain and prevent the heat that triggers complications in darker skin.

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
The patient in this video has ethnic skin tone and acne scars deep enough to require the treatment most practices would refuse.
Dr. Emer performed rebirth: deep fractional erbium first, creating channels that release blood and remove scar tissue, then surface erbium to blend and smooth the top layer. The cheeks, where the scars were worst, received the deepest treatment. The rest of the face was feathered into the hairline and jaw so there are no visible lines when healed.
02The plan
What Dr. Emer decided to do
Depth, heat and aftercare controlled at every step to prevent the complications darker skin is told to expect.
03The session
In the room, in order
Immediately after the laser stopped, Dr. Emer applied bio rain, the patient's own blood plasma mixed with exosomes, stem cells and PDRN. That mixture clots the blood, cools the skin, and starts repair before inflammation can set in. A cooling device followed, bringing the skin temperature down and reducing pain.
- Deep fractional erbium
- Surface erbium
- Bio rain applied immediately
- Cooling device
“So all the blood is coming up through little channels. You want the blood, it actually helps the healing process.”DR. JASON EMER · FROM THE VIDEO
04The result
What changed
The blood you see in the video is intentional. The plasma aftercare is what makes the protocol safe on darker skin. Without it, the risk of hyperpigmentation would be too high to justify the depth.
05What comes next
Recovery and what to expect
The blood coming through the channels is part of the healing process, and Dr. Emer applies what he calls bio rain immediately: the patient's own blood plasma mixed with exosomes, stem cells and PDRN. That mixture clots the blood, cools the skin, and starts the repair before inflammation can set in.
A cooling device follows, bringing the skin temperature down and reducing pain. Without this exact aftercare sequence, the risk of hyperpigmentation on darker skin would be too high to justify the treatment. With it, the protocol works on all skin tones.

Read the complete story +

The patient story

The laser everyone says you cannot use

Deep resurfacing lasers are routinely withheld from darker skin tones because the risk of hyperpigmentation is real. Dr. Emer uses them anyway, on patients with ethnic skin, because he built a protocol that controls the variables that cause the damage: depth, heat, feathering, and what happens in the first minutes after the laser stops.

The patient in this video has darker skin and deep acne scars. The treatment is rebirth: deep fractional erbium followed by surface erbium, then immediate plasma and cooling. The blood you see is intentional, the plasma is processed from his own blood, and the cooling device is part of the plan, not an optional comfort step.

Why erbium, and why this deep

Erbium is colder than CO2, which matters on darker skin. Dr. Emer uses it in two passes: deep fractional erbium first, creating channels that release blood and remove scar tissue, then surface erbium to blend and smooth the top layer.

The depth is adjusted by area. The cheeks, where the scars were worst, received the deepest treatment. The rest of the face was blended and feathered into the hairline and jaw so there are no visible cut offs or lines when healed.

The aftercare that makes it safe

The blood coming through the channels is part of the healing process, and Dr. Emer applies what he calls bio rain immediately: the patient's own blood plasma mixed with exosomes, stem cells and PDRN. That mixture clots the blood, cools the skin, and starts the repair before inflammation can set in.

A cooling device follows, bringing the skin temperature down and reducing pain. Without this exact aftercare sequence, the risk of hyperpigmentation on darker skin would be too high to justify the treatment. With it, the protocol works on all skin tones.

Who this is for

Rebirth is for patients with deep scars, textural damage, or skin that has been told it is too dark for aggressive resurfacing. It requires nerve blocks, strict pre treatment skin care, and a recovery plan that includes downtime and close follow up.

Candidacy is decided in consultation, where Dr. Emer assesses skin tone, scar depth, and whether you can commit to the prep and aftercare that make the result possible without complications.

The treatment, explained

What is erbium laser resurfacing?

Also called deep laser resurfacing, fractional erbium laser, laser resurfacing for ethnic skin, laser resurfacing for darker skin, acne scar laser treatment, ProFractional erbium, TRL Contour laser, RE:BIRTH protocol.

What it is: RE:BIRTH is Dr. Emer's deep laser resurfacing protocol for all skin tones, including ethnic skin. It combines deep fractional erbium laser (ProFractional) to create channels that remove scar tissue and release blood, followed by surface erbium (TRL Contour) to resurface the top layer. Erbium laser runs colder than CO2, making it safer for darker skin when settings and aftercare are controlled. Immediately after the laser, the patient's own blood plasma mixed with exosomes, stem cells and PDRN (bio rain) is applied while the skin is bleeding, then a cooling device (glacial) brings the temperature down. This aftercare sequence prevents the hyperpigmentation and poor healing that make other practices refuse deep resurfacing on ethnic skin. RE:BIRTH treats acne scars, sun damage, texture and tone issues that require aggressive resurfacing.
How it works: The procedure begins with deep fractional erbium laser creating channels through the dermis. These channels release blood and remove scar tissue. The depth is adjusted by zone: deepest where scars or damage are worst, lighter on the rest of the face. Surface erbium then resurfaces the entire top layer, feathered into the hairline and jaw to prevent visible lines when healed. Immediately after the laser stops, bio rain (the patient's own blood plasma processed with exosomes, stem cells and PDRN) is applied while the skin is still bleeding. The plasma clots the blood and starts repair before inflammation can set in. A glacial cooling device follows, bringing skin temperature down and reducing pain. The entire protocol is designed around the variables that cause hyperpigmentation in darker skin: heat, inflammation and aftercare timing.
Who it is for: RE:BIRTH is for patients with acne scars, sun damage, texture or tone issues that require deep resurfacing, including patients with ethnic skin tones who have been told their skin is too dark for aggressive laser treatment. Candidacy depends on your skin type, the condition being treated, and whether you can commit to the pre-treatment skin care and aftercare protocol. Patients come to Dr. Emer when they have been refused treatment elsewhere or when previous lasers left hyperpigmentation or uneven results. The right prep before the laser and exact adherence to the aftercare protocol are what allow deeper settings on darker skin without complications. Candidacy and treatment depth are determined during consultation.
Recovery: RE:BIRTH is a deep resurfacing procedure with significant downtime. Immediately after treatment, the skin is raw, bleeding and looks like a burn. Redness, peeling, swelling and healing follow. The exact recovery timeline depends on the depth of treatment your skin requires and is discussed during consultation. Nerve blocks are used during the procedure and the cooling device reduces pain immediately after, but this is an aggressive treatment. Pre-treatment skin care and strict adherence to the aftercare protocol (plasma application, cooling, post-procedure products) are required to prevent complications, especially on darker skin.
When results show: Results develop as the skin heals and new collagen forms. The timeline varies by depth of treatment and individual healing. Improvements in scar depth, texture, tone and overall skin quality become visible as healing progresses. Long-term results depend on the condition treated, the depth of resurfacing performed, and adherence to the aftercare and maintenance plan. Results are discussed and planned during consultation based on your skin and goals.

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.

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From Dr. Emer's Instagram

The work, as he shows it.

@jasonemermd @recodexsystem

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Why Dr. Emer

The laser everyone withholds. He uses it anyway.

Deep resurfacing on darker skin is routinely refused because the risk is real. Dr. Emer built a protocol that controls the risk.

Two decades of laser work, a global patient base, and outcomes on skin tones other surgeons turn away. Dr. Emer performs every procedure himself and has refined the rebirth protocol to work on all skin types when the prep, settings and aftercare are followed exactly.

Patients come to him when they have been told their skin is too dark for aggressive resurfacing, or when previous treatments left hyperpigmentation or uneven texture. The difference is not the laser. It is the plan around it.

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^™

Erbium, not CO2

Erbium is colder than CO2 and can be used on ethnic skin when the settings and aftercare are right.

Immediate plasma aftercare

Bio rain is applied while the skin is still bleeding, starting repair before inflammation can set in.

Cooling before swelling

The glacial device brings skin temperature down immediately, reducing pain and preventing the heat that triggers pigment changes.

Pre treatment skin care

The right prep before the laser is what allows deeper settings without complications on darker skin.

Asked plainly, answered plainly

What patients ask before they book.

Can you do deep laser resurfacing on darker skin?+

Yes. Dr. Emer performs RE:BIRTH on ethnic skin tones using erbium laser, which runs colder than CO2, with immediate plasma and cooling aftercare designed to prevent hyperpigmentation. Candidacy depends on your skin type, the condition being treated, and whether you can commit to the pre-treatment prep and aftercare protocol. That is determined during consultation.

What is the difference between erbium and CO2 laser?+

Erbium laser runs colder than CO2, making it safer for darker skin tones when the settings and aftercare are controlled. Dr. Emer uses erbium for RE:BIRTH because the lower heat reduces the risk of hyperpigmentation in ethnic skin. The protocol combines deep fractional erbium with surface erbium, or in some cases a combination of erbium and CO2, depending on the patient's skin and goals.

Will I get hyperpigmentation after laser resurfacing?+

The RE:BIRTH protocol is designed to prevent hyperpigmentation, but the risk is never zero on darker skin. Pre-treatment skin care, exact laser settings adjusted by zone, and immediate plasma and cooling aftercare are what control the risk. Dr. Emer has refined this protocol over two decades of laser work on all skin tones. If you skip the prep or aftercare, the risk goes up.

What is bio rain and why is it used?+

Bio rain is the patient's own blood plasma processed with exosomes, stem cells and PDRN. It is applied immediately after the laser while the skin is still bleeding. The plasma clots the blood, cools the skin and starts repair before inflammation can set in. On darker skin, this immediate aftercare is what prevents the hyperpigmentation and poor healing that make other practices refuse deep resurfacing.

How painful is RE:BIRTH laser resurfacing?+

RE:BIRTH is painful. Nerve blocks are used during the procedure to manage pain while the laser is running. Immediately after, the glacial cooling device brings skin temperature down and reduces pain. This is an aggressive resurfacing treatment, not a light procedure. Pain management and recovery expectations are discussed during consultation.

What is the downtime for deep erbium laser resurfacing?+

RE:BIRTH has significant downtime. Immediately after treatment, the skin is raw, bleeding and looks like a burn. Redness, peeling, swelling and healing follow. The exact timeline depends on the depth of treatment your skin requires, which is determined during consultation. Deeper settings on areas with worse scars mean longer healing in those zones.

Can RE:BIRTH treat acne scars on ethnic skin?+

Yes. The patient in the video has ethnic skin tone and deep acne scars. Dr. Emer used the deepest settings on the cheeks where the scars were worst, lighter settings on the rest of the face, and feathered the treatment into the hairline and jaw to prevent visible lines. The immediate plasma and cooling aftercare prevented hyperpigmentation. Candidacy and treatment depth are determined during consultation based on your scars and skin type.

Why have other doctors refused to do deep laser resurfacing on my skin?+

Most practices refuse deep resurfacing on darker skin because the risk of hyperpigmentation is real if the protocol is not controlled. Dr. Emer performs RE:BIRTH on ethnic skin tones because he has built a protocol around the variables that cause complications: erbium instead of CO2, exact settings by zone, immediate plasma aftercare while the skin is bleeding, and cooling to prevent the heat and inflammation that trigger pigment changes. The difference is not the laser. It is the plan around it.

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

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