Jason Emer, MD, FAAD, FACS
Fully Ablative Erbium Laser For Deep Acne Scars: What The Treatment Actually Does
How Dr. Jason Emer uses fully ablative erbium resurfacing to blend and improve severe acne scarring and texture, even in sensitive or pigmented skin.
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.
Fully ablative erbium resurfacing over silicone micro droplet and Sculptra foundation, performed awake with nerve blocks on Fitzpatrick II skin with pigmentation, blending severe acne scarring in one session.
Your plan starts with Dr. Emer.
Schedule ConsultationReserve online. West Hollywood and New York.
From the filmed session
What Dr. Emer did · CELESTA
Silicone micro droplets and Sculptra injected beneath depressed acne scars to raise the base and create a foundation before surface resurfacing.
“underneath that is silicone micro droplet and sculpture”
Dr. Emer, in the film
Fully ablative erbium TRL contour laser passes at 90 degrees to remove the entire top layer of skin, blend texture, and cauterize as it resurfaces. Specific settings for pigmented skin with aggressive post care protocol.
“we're using the fully ablative herbium to blend the surface and try and get a big improvement on the overall texture of her skin”
Dr. Emer, in the film
Nerve blocks and topical anesthetic applied to allow the patient to tolerate the fully ablative treatment awake without sedation.
“It takes a lot of strength to do this awake. I don't know how she did it, but she did a great job.”
Dr. Emer, in the film
Why patients fly in
Dr. Emer performs fully ablative erbium resurfacing on patients with pigmentation and sensitive skin tones using specific laser settings and aggressive post care protocols that most practices avoid.
“Not a lot of people are able to do sensitive skin tones with stronger lasers. And she has a little bit of pigmentation, but with the right postc care and settings, which we're doing very specific ones right now, she'll do really, really well.”
Erbium laser is chosen over CO2 for patients with any pigmentation because it carries lower risk of post-inflammatory hyperpigmentation while still delivering fully ablative depth.
“herbium's a lot safer anyways than like a CO2 laser for example”
The laser is held at exactly 90 degrees and moved in methodical passes to avoid leaving lines, grooves, or uneven texture, with continuous blending throughout the treatment.
“the key is with this laser very meticulous. You don't want to leave lines or grooves. And so you got to be very very very 90° methodical.”
Silicone micro droplet and Sculptra are placed under the scars first to raise the depressed areas from beneath, then the laser blends the surface on top of that foundation.
THE THINKING BEHIND THE TREATMENT
Follow Dr. Emer’s approach through the stages described in this case.
Back to the video ↗She had silicone micro droplet filler and Sculptra placed under the scars first. This session blends the surface.
The patient in this video has severe acne scarring and texture irregularities. Before this laser session, Dr. Emer placed silicone micro droplet filler and Sculptra beneath the depressed scars to raise them from underneath. This session is the surface layer: fully ablative erbium laser resurfacing to blend the texture on top of that foundation.
Fully ablative means the laser removes the entire top layer of skin in the treated area. It is one of the most aggressive resurfacing treatments available, and it requires strength to tolerate awake. She did it with nerve blocks and topical anesthesia, no sedation, and the result is a more even skin surface than either filler or laser alone could produce.
Texture and scarring, treated as one plan / Patient story
She had silicone micro droplet filler and Sculptra placed under the scars first. This session blends the surface.
The patient in this video has severe acne scarring and texture irregularities. Before this laser session, Dr. Emer placed silicone micro droplet filler and Sculptra beneath the depressed scars to raise them from underneath. This session is the surface layer: fully ablative erbium laser resurfacing to blend the texture on top of that foundation.
Fully ablative means the laser removes the entire top layer of skin in the treated area. It is one of the most aggressive resurfacing treatments available, and it requires strength to tolerate awake. She did it with nerve blocks and topical anesthesia, no sedation, and the result is a more even skin surface than either filler or laser alone could produce.
The patient in this video has deep acne scars and texture irregularities that have already been treated with silicone micro droplet filler and Sculptra placed under the skin. This session is the surface layer: fully ablative erbium laser resurfacing to blend the texture and improve the overall appearance of the skin.
Fully ablative means the laser removes the entire top layer of skin in the treated area. It is one of the most aggressive resurfacing treatments available, and it requires strength to tolerate awake. This patient did it with nerve blocks and topical anesthesia, no sedation.
Erbium is safer than CO2 laser for patients with any pigmentation or sensitivity. The patient in this video has a light skin tone with some pigmentation, and Dr. Emer chose erbium with specific settings and aggressive post care to minimize the risk of pigment changes after the treatment.
The technique is meticulous: the laser must be held at 90 degrees to avoid leaving lines or grooves, and the entire surface is blended in passes to ensure an even result. Early in the session there is visible bleeding as the top layer of skin is removed; by the end the tissue is cauterized and the surface is uniform.
How a session is built
Planned around your skin tone, your scarring, and the level of resurfacing that makes sense for your case.
Nerve blocks and topical anesthesia are applied to allow the treatment to be performed awake.
The laser is held at 90 degrees and moved in meticulous passes to remove the top layer of skin without leaving lines or grooves.
The entire treated area is blended to ensure an even result, with extra attention to areas where scars are deepest.
Healing requires strict post care to protect the new skin and minimize the risk of pigment changes.
The treatment, explained
Also called erbium laser resurfacing, erbium TRL, acne scar laser treatment, ablative laser resurfacing, laser skin resurfacing for scars, erbium YAG laser.
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 results, a global patient base, and techniques other physicians travel to learn.
Dr. Emer built his reputation on outcomes that read as natural and precise, even in the most challenging cases. He performs advanced scar revision and laser resurfacing on a range of skin tones, including patients with pigmentation or sensitivity, using specific settings and post care protocols that other practices avoid.
Patients come to him when the scarring is severe, when gentler treatments have not worked, and when the result has to be both aggressive and safe.
Erbium is safer than CO2 for patients with any pigmentation or sensitivity, when used with the right settings and post care.
The laser must be held at 90 degrees and moved in careful passes to avoid leaving lines, grooves or uneven texture.
Filler placed under the scars first raises the base, and the laser blends the surface on top of that foundation.
Asked plainly, answered plainly
Yes. Dr. Emer performs fully ablative erbium resurfacing on patients with pigmentation and sensitive skin tones, including Fitzpatrick II through IV, using specific laser settings and aggressive post care protocols tailored to each case. Erbium is safer than CO2 for patients with any pigmentation because it carries lower risk of post-inflammatory hyperpigmentation while still delivering fully ablative depth.
Yes. The patient in this video had nerve blocks and topical anesthesia and tolerated the fully ablative treatment awake without sedation. Dr. Emer notes that it takes significant strength to do this awake, and sedation is also an option for patients who prefer it.
Many patients with deep, depressed acne scars benefit from silicone micro droplet filler and Sculptra placed beneath the scars to raise the base before the laser blends the surface. This combination approach addresses both the depth and the texture of the scarring. Whether you need filler first is determined during consultation based on your specific scarring pattern.
Fully ablative resurfacing requires significant healing time. The skin will be raw immediately after treatment and will form a new surface layer over the following weeks. Aggressive post care is required to protect the new skin and minimize the risk of pigment changes. The specific downtime and post care protocol are discussed during consultation based on your skin tone and the depth of treatment.
Fully ablative erbium removes the entire top layer of skin in the treated area, while fractional treatments create columns of injury surrounded by untreated skin. Fully ablative resurfacing is more aggressive and delivers more dramatic improvement for severe scarring, but it also requires more downtime and stricter post care. The choice between fully ablative and fractional is made during consultation based on your scarring, skin tone, and tolerance for downtime.
The laser must be held at exactly 90 degrees and moved in meticulous passes to avoid leaving lines, grooves, or uneven texture. Dr. Emer continuously blends the treated area throughout the session to ensure an even result. Poor technique can leave visible lines or create new texture irregularities instead of improving them.
The number of sessions depends on the severity of your scarring and your skin's response to treatment. Some patients see significant improvement in one session, while others may benefit from additional sessions spaced several months apart. Your treatment plan is determined during consultation based on your specific case.
Fully ablative resurfacing requires aggressive post care to protect the new skin and minimize the risk of pigment changes. The specific protocol is tailored to your skin tone and the depth of treatment performed. Dr. Emer provides detailed post care instructions at the time of your treatment.
A consultation with Dr. Emer covers your scarring, your skin tone, and whether fully ablative erbium resurfacing fits your case.
Schedule ConsultationWest Hollywood and New York City