Erbium YAG | CO2 Fraxel

Laser Resurfacing Treatment Options in Amarillo

The two workhorses of ablative technology are CO2 and Erbium:YAG. The Sandstone™ Cortex™ from Ellman International is the only skin-resurfacing laser system to include not one, but both the CO2 and Erbium:YAG wavelengths in the same FDA Approved Laser Body. This innovative device offers fractional CO2 with an adjustable density for up to 95% coverage plus full-coverage Erbium:YAG. The dual wavelengths allows us to perform resurfacing procedures on a wide range of skin types and for multiple indications noted below. The CO2  laser penetrates deeply and provides heat to stimulate collagen, while the Erbium:YAG laser helps to soften the texture of the epidermis and remove pigmentation from the superficial layers of the skin. The Cortex is widely recognized as the only laser that offers such flexibility with numerous treatment parameter options and we love this laser! Unlike systems that have one time use consumables the Cortex does not require them to provide treatments. We are able to pass the savings on to our patients and make treatments more affordable.  


The Erbium:YAG modality in the Cortex allows for finer control of the energy and precise superficial tissue ablation, with multiple spot sizes and energy options available. Clinical indications that can be addressed include photo damage, mild to moderate rhytides (Wrinkles), uneven pigmentation and seborrheic keratosis. By combining a proprietary fluence level with an extra-long pulse width, the Erbium precisely ablates the epidermis without exposing the underlying dermis underneath. The gentler nature of the Erbium wavelength allows the physician to treat highly sensitive areas on the neck, dorsal hands, perioral and periorbital areas without the need for anesthesia and or only minimial anesthetia necessary to perform comfortable treatments. 


With the Cortex System, we can select multiple settings, including size, shape, density and duration, to tailor the treatment to each individual patient for optimal dermal penetration, healing and post-treatment results. Clinical indications that can be treated include rhytides (wrinkles), fine lines, acne scars, photo damage, textural irregularities and pigmented lesions. 

Which Wavelength & Option Does What?

Er:YAG - Erbium YAG



Eribum YAG is best for superficial things like fine lines & wrinkles, improving the appearance of larger pore sizes, triggering positive textural changes, targeting more surface photo damage, and improving those who have a sallow complexion in the areas they are seeking to treat. This can be used on the body and the face, giving us a great tool to revitalize and repair tissue and it can be used with minimal risks on most skin types 3 through lighter 4's and 5's since we are targeting more of the Epidermis than the Dermis.  Those with Skin Types 3-lighter 4's and 5's are suggested to use lightening creams post their treatment on day 15 to keep the skin from having a post inflammatory response that can leave the melanin production in more of a high state. Sun Screen and a specific regimen are needed to maintain the best results. 


The erbium: YAG (Er:YAG) laser is a new addition to the armamentarium of skin resurfacing lasers. This laser, with a wavelength of 2940 nm, produces laser irradiation in the near infrared portion of the electromagnetic spectrum. This wavelength corresponds to the main peak of water absorption. The water absorption coefficient is 12,800/cm, compared with the CO2 laser water absorption coefficient at 800/cm. The Er:YAG laser can remove as little as 1 mm of skin with a single laser impact; the ablation threshold is only 1.6 J/cm2. The Er:YAG laser releases pulses of 250 to 350 us duration. It has been suggested that these attributes lead to the observed faster wound healing and shorter duration of erythema after Er:YAG laser resurfacing compared to the CO2 Fraxel laser resurfacing. 

Carbon CO2 Fraxel



CO2 in its Fraxel, Pixel, and or Modified form can things deeper in the dermis like general chronological aging that affects everyone over time, improving skin elasticity, reaching deeper photo damage that includes laxity and encouraing positive changes to lighten up darker areas, early rhytids (wrinkles) that happen simply from normal facial expression and sleeping positions, scaring of all kinds, healing skin post acne damage from lots of breakouts, tackling superficial facial spider veins, the ablation and resurfacing of soft tissue, improving stretch marks on the body and repairing the tissue appearance from over stretched skin, textural irregularities and addressing larger pores by helping them shrink. This can be used on the body and the face, giving us a great tool to revitalize and repair tissue and it can be used with minimal risks on most skin types since we are targeting more of the Dermis than the Epidermis. Those with Skin Types 3-6 are suggested to use lightening creams post their treatment on day 15 to keep the skin from having a post inflammatory response that can leave the melanin production in more of a high state. Sun Screen and a specific regimen are needed to maintain the best results. 


The Cortex Fractional CO2 Laser emits light at a wavelength  of 10,600 nm. The light is absorbed strongly by water down to the lower  dermis. Each pulse of CO2 energy vaporizes a microscopic  column of tissue, leaving small areas of untreated skin between columns.  As ablation occurs, deep heating stimulates collagen growth and  remodeling. Distributing the laser energy in an even pattern allows for  quicker healing and reduces patient downtime.

Combining CO2 & Er: YAG



All fractionally ablative resurfacing devices are far from equal. Before the introduction of the Cortex Laser, typical fractionally ablative lasers penetrated the skin to a depth of 400 to 800 µm. The  Er:YAG light source provides full surface ablation to a depth of 100 µm, allowing the Cortex Laser to achieve maximum flexibility in a single device.

Fractional CO2 and fully ablative Er:YAG work synergistically for a variety of indications. For example, performing a shallow and fully ablative Er:YAG treatment after fractional CO2 resurfacing removes the zone of thermal necrosis created by the CO2 treatment.   Ablating the epidermis in this manner promotes prompt healing and reduces the duration of crusting, swelling, and itching after fractional  CO2 treatment. In combination, these procedures can  substantially improve medium to deep (Grade III) facial rhytids and or static wrinkles.  

Most patients are able to heal faster when we are able to use both options for a layered treatment. Targeting both deep and more surface issues in one single treatment. Which can certainly help amplify ones results with the ability to work on more Chromophores and or problem areas/items. 

Many Patients heal in 3-4 days, without the combination, healing with the CO2 Fraxel passes alone may take up to one week. Less Downtime is another perk. 


Medical devices | items

The Sandstone™ Cortex™

Er:YAG 2940 nm

CO2 10,600nm

Zimmer Cryo 6 

Topical Benzocaine 20%, Lidocaine 10%, and Tetracaine 10% 


Post Care Kits Available for $75 

timeline for results

Results can typically be seen post the peel or light scabbing has healed, however non ablative and ablative lasers have been shown to stimulate collagen and there is a histochemical effect that improves the skin. In 3 to 6 months, patients will look better than they look at 2-4 weeks. Sometimes your skin will look less volumized post given the length of time it takes for the collagen cycle to be complete itself. Its important to note everyone will have their own personal response to their treatment(s) and some may need more than 1-2 to get the results they are seeking. 

pain level

Prescription Anesthetic used Topical Benzocaine 20%, Lidocaine 10%, and Tetracaine 10% 

Applied for 20-45 Minutes 


None to Mild | 0-2/10 on avg. per patient feedback

CO2 Fraxel

Minimial to Mild | 0-3/10 on avg. per patient feedback

length of appointment

Times Noted Below On Specific Options 

From 15 Minute to 2 Hours Needed

Bring a Book, Your Phone, and Relax in a treatment room while you numb. 

average recovery time



2-4 Days 

Light Flake - Light Peel

Chest/Body/ Target Areas

5-7 Days 

Light Flake - Light Peel

CO2 Fraxel 


3-5 Days 

Light Peel - Medium Peel

Chest/Body/Scars/Stretch Marks

3-5 Days 

Light Peel - Medium Peel


For those who are not good patient fits for either option above due to being a darker skin type 4 or 5, skin types 6, those who have Melasma, and or who dont have time to handle a light peel and or 3-4 days of at home recover time - we would suggest Microneedling as a safer and lower risk option to yield similar results with a few more sessions and lower downtime than the two choices and or combination of the above here. Adding PRP to Microneedling can help accelerate results too. 

Laser Resurfacing Option Pricing

Options For Those Who Aren't Canidates for Laser Resurfacing

Plain Microneedling


Safe for All Skin Types 1-6

1 Day of Downtime

Best in Series of 3 

Sessions 4-6 Weeks Apart

Great Year Round Option

PRP Injections & Microneedling

Platelets Rich Plasma, PRP, Liquid Gold, Scars, Stretch Marks, Acne, Pigmentatio, Wrinkles, Rhytids

Safe for All Skin Types

1-2 Days of Downtime

Best in Series of 3 

Sessions 4-6 Weeks Apart

Great Year Round Option

VI Chemical Peels

VI Chemical Peels, Peeling Skin, Acne, Wrinkles, Pigment, Scars, Wrinkles, Fine Lines, Medical Grade

Safe for All Skin Types

1-2 Days of Downtime

3-7 Days of Light Peeling

Best in Series of 2-4 

Sessions 4-6 Weeks Apart

Great Year Round Option

Patient Documentation For This Treatment Below

Download These Documents to Save Time and Learn More About Pre and Post Care Recommendations 

Files coming soon.

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Progress MD

5461 McKenna Square, Suite 201, Amarillo, TX 79119, US

Our office is out in Town Square in front of Air U Amarillo with other local businesses like Lawyers Title of Amarillo, Town Square Nutrition, and Cask & Cork Restaurant. Lot and Street Parking Available


Mon: Closed  

Tue: 12:00PM-8:00PM  

Wed: 10:00AM-6:00PM  

Thu: 12:00PM-8:00PM  

Fri: 10:00AM-6:00PM  

Sat: 10:00AM-4:00PM  

Sun: 10:00AM-4:00PM*  

(Typically first 2 Sundays of the month)