LA&HA - Journal of the Laser and Health Academy
Volume: 2026 | number: 1
ISSN (web): 1855-9921
SuperSMOOTH: Leveraging Gate Control Theory in Aesthetic Treatments Using a Novel Er:YAG Laser Modality
Matjaž Lukač, Jure Košir, Matej Senegačnik, Tea Osterc Diwersy, Monika Koren, Irena Hreljac
Pages: onlineFirst
SuperSMOOTH™ is a novel Er:YAG laser pulse modality that enables the simultaneous delivery of non-ablative and ablative effects within a single treatment step. Originally developed to optimize multi-step procedures combining Er:YAG and Nd:YAG lasers (such as Fotona4D®), SuperSMOOTH also represents an effective standalone treatment approach for skin rejuvenation.
By combining deep thermal stimulation with controlled superficial ablation, SuperSMOOTH enables efficient tissue remodeling and improves pigmentation and skin texture in a single pass. Additionally, results from the pilot studies presented in this paper indicate that this modality uniquely leverages the gate control theory of pain, resulting in an approximately 30% reduction in perceived pain compared to conventional non-ablative Fotona SMOOTH® Er:YAG laser treatments—exceeding the effect of topical anesthesia under the tested conditions.
These characteristics position SuperSMOOTH not only as an enabling technology within multi-wavelength protocols, such as Fotona4D®, but also as an independent treatment modality capable of delivering fast, effective, and well-tolerated skin rejuvenation treatments. The importance of the reduced pain perception effect as observed in this study is not merely improved comfort, but the ability to use clinically effective treatment parameters without increasing patient discomfort.
Key words: Smooth, SuperSmooth, Er:YAG laser, Fotona4D, gate control theory, skin rejuvenation, pain perception.