Jason Emer, MD, FAAD, FACS
Deep Erbium Laser For Acne Scars On Ethnic Skin: Why This Patient Peels For Ten Days And Comes Back
How Dr. Jason Emer treats severe acne scarring on ethnic skin using deep fractional erbium combined with superficial ablative erbium, going deeper than phenol peels with less risk.
Dr. Jason Emer MD · FAAD · FACS
The practice's own photographs
Patients of the practice, from Dr. Emer's published before and after gallery. Each case is one patient. Individual results vary.
Deep fractional erbium penetrating hundreds of microns into the dermis, combined with superficial ablative erbium at high density and power, remodels severe acne scarring on ethnic skin that most practices turn away.
Your plan starts with Dr. Emer.
Schedule ConsultationReserve online. West Hollywood and New York.
From the filmed session
What Dr. Emer did · RE:SKN
Micro drops of silicone placed into depressed scars to restore volume from beneath, performed in prior sessions to build foundation before surface remodeling.
“We've been working on his scars with micro drop of silicone which has filled out the volume. Now the surface texture needs to be addressed.”
Dr. Emer, in the film
Profractional erbium at high density and high power, drilling hundreds of microns into the dermis to remodel scar tissue from the inside out, deeper than phenol peel penetration.
“This is fractional but this is quite high uh density and high um power. You guys can see how deep this is going because of the number of dots over here versus over there that's been blended.”
Dr. Emer, in the film
Contour TRL erbium ablative resurfacing on the surface layer, combined with deep fractional to address every layer of scar tissue at different depths.
“Each of these are different depths. So we can address every layer.”
Dr. Emer, in the film
Why patients fly in
Deep fractional erbium penetrates hundreds of microns into the dermis, far deeper than phenol peels which ablate only the surface. The laser drills holes into the tissue to remodel from the inside out.
“This is going hundreds of microns in depth. So, that's how you get an improvement of laser over a deeper peel. Although peels are good, the only peels that would work are very, very, very deep and they could higher much higher risk than even the laser for scarring.”
Most physicians will not perform aggressive laser resurfacing on ethnic skin because hyperpigmentation risk is high. Dr. Emer has built his dermatology practice on treating the cases other offices decline, with strict protocols to manage darkening.
“Hyperpigmentation is really high and it's someone with an ethnic skin tone. There's a high risk. Many doctors won't even do this, but it's our specialty. It's something I've been doing for years.”
The Reskin Stabilis protocol is required before and during treatment: vitamin C, hyaluronic acid, growth factors, peptides, stem cells, papaya enzyme cleansers, retinol and hydroquinone. Without compliance, the laser is not performed.
“a very aggressive skin care co protocol called reskin stabilis that has in it vitamin C, hyaluronic acid, growth factors and peptides, stem cells, exfoliating cleansers made of papaya enzyme and retinol and hydroquinone and we that is required. If you don't do it, you can't do the laser.”
Two lasers at different depths, high density and high power, each addressing a different layer of scar tissue. The combination of deep fractional and superficial ablative treats every plane from dermis to surface.
“Each of these are different depths. So we can address every layer.”
After the initial series achieves the goal, maintenance treatments every three to four months with Halo, Fraxel, microneedling or microneedling radiofrequency keep the result. This is not a single visit fix.
“After this, we would do maintenance treatments once he's happy with the result. Things like halo or fraal with micro needling or micro needling radio frequency every so often, usually every 3 to 4 months and you would maintain”
THE THINKING BEHIND THE TREATMENT
Follow Dr. Emer’s approach through the stages described in this case.
Back to the video ↗Severe scarring treated in stages, with microscopic silicone filling volume and laser remodeling texture.
This patient has very severe acne scarring. The goal is scars first, texture second, with residual hyperpigmentation addressed later through peels and skin care. He has already had this procedure a couple of times before, with big improvement each session.
Deep fractional erbium combined with superficial ablative erbium, each at different depths to address every layer of scar tissue.
“Our goal is just scars. We got to get these as good as we possibly can. And by going deeper, combining the microscopic silicone and the combination of two strong lasers, we can get a bigger outcome.”DR. JASON EMER · FROM THE VIDEO
The scars have been filled with microscopic silicone to restore volume. Now the surface texture is being addressed with the laser combination. He will peel for seven to ten days, follow the required skin care protocol, and return for maintenance treatments every three to four months once he is happy with the result.
“So, this is Profactional. We're going to go to our contour laser. I'll see you guys soon. You'll watch him daily because we're going to see him peel.”DR. JASON EMER · FROM THE VIDEO
“We've been working on his scars with micro drop of silicone which has filled out the volume. Now the surface texture needs to be addressed.”DR. JASON EMER · FROM THE VIDEO
This is a bigger treatment to get the patient somewhere. After this, maintenance treatments are required once he is happy with the result. That means treatments like Halo or Fraxel with micro needling or micro needling radio frequency every three to four months.
Every treatment is customized. Dr. Emer does not know the pricing until he knows what needs to be done, how many sessions are required, and whether it needs to be combined with filler, TCA cross, or subsision. This is a long term investment in the skin, not a single visit fix.
Deep fractional erbium for severe acne scarring / Patient story
Severe scarring treated in stages, with microscopic silicone filling volume and laser remodeling texture.
This patient has very severe acne scarring. The goal is scars first, texture second, with residual hyperpigmentation addressed later through peels and skin care. He has already had this procedure a couple of times before, with big improvement each session.
The scars have been filled with microscopic silicone to restore volume. Now the surface texture is being addressed with the laser combination. He will peel for seven to ten days, follow the required skin care protocol, and return for maintenance treatments every three to four months once he is happy with the result.
Hyperpigmentation is the barrier. Many physicians will not perform aggressive laser resurfacing on ethnic skin because the risk of darkening is high, and the protocols to prevent it are strict. This patient has very severe scarring, and the goal is scars first, texture second, with residual hyperpigmentation addressed later through peels and skin care.
Dr. Emer uses a combination of deep fractional erbium and superficial ablative erbium, both at high density and high power. The depth is visible in the density of the dots on the skin during treatment. This is not a single pass maintenance laser. This is drilling hundreds of microns into the dermis to remodel scar tissue from the inside out.
Phenol peels are ablative on the surface, removing the top layer of skin. The deep fractional erbium used here penetrates hundreds of microns in depth, reaching layers a peel cannot. That is how laser achieves improvement over even a very deep peel, and it does so with lower risk of scarring than the deepest chemical peels.
The patient in this video has already had this procedure a couple of times before, with big improvement each session. The scars have been filled with microscopic silicone to restore volume, and now the surface texture is being addressed with the laser combination.
How a session is built
Deep fractional erbium combined with superficial ablative erbium, each at different depths to address every layer of scar tissue.
A very aggressive skin care protocol called Reskin Stabilis is required before treatment. It includes vitamin C, hyaluronic acid, growth factors and peptides, stem cells, exfoliating cleansers made of papaya enzyme, and retinol and hydroquinone. If you do not follow the protocol, you cannot do the laser.
Deep fractional erbium penetrates hundreds of microns into the dermis, going deeper than even a phenol peel. Superficial ablative erbium addresses the surface. Each layer is treated at a different depth to remodel scar tissue from the inside out.
Patients are on antibiotics, sometimes steroids if needed, and they peel for seven to ten days. Pain management includes nerve blocks, topical creams, pills, and shots. Nitrous is available, and the procedure can be performed in the operating room under sedation if needed.
After the scars are where the patient wants them, maintenance treatments like Halo or Fraxel with micro needling or micro needling radio frequency are performed every three to four months.
The treatment, explained
Also called Profractional erbium, Contour TRL erbium, superficial ablative erbium, erbium laser resurfacing, acne scar laser treatment, laser resurfacing for ethnic skin, deep laser resurfacing, fractional laser for acne scars.
Signature procedures
Peptides / biologic optimization
Peptide and biologic protocols for recovery, body composition and longevity, with epigenetic testing. RECODEX™ peptides are available to purchase through the practice after consultation.
Why Dr. Emer
Two decades of laser resurfacing on skin types most practices turn away.
Hyperpigmentation is the barrier. Many physicians will not perform aggressive laser resurfacing on ethnic skin because the risk of darkening is high, and the protocols to prevent it are strict. Dr. Emer has built his dermatology practice on treating the cases other offices decline.
He uses a combination of deep fractional erbium and superficial ablative erbium, both at high density and high power, penetrating hundreds of microns into the dermis to remodel scar tissue. The protocol is not optional: a very aggressive skin care regimen, antibiotics, sometimes steroids, and close follow up through the peel.
The deep fractional erbium used here reaches layers a peel cannot, remodeling scar tissue from the inside out.
Each laser is set to a different depth and density, addressing every layer of the scar without over treating the surface.
The risk of scarring is lower than the deepest chemical peels, and the protocol manages hyperpigmentation risk on ethnic skin.
Every treatment is customized. Dr. Emer does not know the pricing until he knows what needs to be done, how many sessions are required, and whether it needs to be combined with filler, TCA cross, or subsision.
Asked plainly, answered plainly
Yes, but only with a strict protocol. Hyperpigmentation risk is high on darker skin tones, and many physicians will not perform aggressive laser resurfacing on ethnic skin. Dr. Emer has built his dermatology practice on treating the cases other offices decline. The mandatory Reskin Stabilis skin care protocol includes vitamin C, hyaluronic acid, growth factors, peptides, stem cells, papaya enzyme cleansers, retinol and hydroquinone. Patients are also on antibiotics and sometimes steroids during healing. Without compliance with this protocol, the laser is not performed.
It depends on the severity of the scarring and the patient's goal. The patient shown in the film is on his third session and has had big improvement each time. Multiple sessions are usually required, spaced months apart. After the scars are where the patient wants them, maintenance treatments with Halo, Fraxel, microneedling or microneedling radiofrequency are performed every three to four months to maintain the result. The number of sessions and timeline are determined at consultation.
Patients peel for seven to ten days after treatment. They are on antibiotics and sometimes steroids during the peel, and they must follow the mandatory Reskin Stabilis skin care protocol during healing. Pain is managed with nerve blocks, topical anesthetic creams, oral medication and injections. Nitrous oxide is available, and the treatment can be performed under sedation in the operating room if needed.
Deep fractional erbium penetrates hundreds of microns into the dermis, far deeper than phenol peels which ablate only the surface. The laser drills microscopic columns into the tissue to remodel scar tissue from the inside out. Phenol peels that would be deep enough to match this effect carry a much higher risk of scarring than the laser. The combination of deep fractional and superficial ablative erbium at different depths treats every layer of the scar.
Reskin Stabilis is a very aggressive skin care protocol required before and during deep erbium laser treatment. It includes vitamin C, hyaluronic acid, growth factors, peptides, stem cells, papaya enzyme cleansers, retinol and hydroquinone. The protocol manages hyperpigmentation risk on ethnic skin, which is very high with aggressive laser resurfacing. Without compliance with this protocol, the laser is not performed. This is not optional.
Yes. The patient shown in the film has had microscopic silicone injections in prior sessions to restore volume beneath depressed scars before the laser addresses surface texture. Deep erbium laser can also be combined with TCA cross for deep ice pick scars and subsision to release tethered scars. The combination of treatments is determined at consultation based on the type and severity of scarring.
Every treatment is customized. Dr. Emer does not know the pricing until he knows what needs to be done, how many sessions are required, and whether the laser needs to be combined with other treatments like microscopic silicone, TCA cross or subsision. This is a long-term investment in the skin, not a single visit fix. Patients must be willing to commit to ongoing skin care and maintenance treatments every three to four months after the goal is achieved. Pricing is discussed at consultation.
Pain is managed with nerve blocks, topical anesthetic creams, oral pain medication and injections. Nitrous oxide is available for patients who need it. The treatment can also be performed under sedation in the operating room if needed. The specific pain management plan is determined at consultation based on the patient's needs and the extent of treatment.
A consultation with Dr. Emer covers your scarring, your skin type, and whether deep erbium laser resurfacing fits your plan.
Schedule ConsultationWest Hollywood and New York City