$Man with mild acne scarring, illustrating fractional pico laser for acne scars$

Acne Scars · Fractional Pico · Scar Types · Orchard Road

Pico Laser for Acne Scars: What It Can and Cannot Do

A gentle remodelling tool, not a scar eraser.

Fractional picosecond laser has a real but limited place in acne scar treatment. Dr Sin Yong at IN Eternity Clinic on Orchard Road explains which scars it helps, which it does not, and what it is usually combined with.

WhatsApp to Enquire →Key facts ↓

Micro-spots

Lens-array delivery

Shallow

Epidermis and upper dermis

1–2 days

Typical redness

Course

Several sessions

Key facts

Fractional delivery: a diffractive or microlens array splits the picosecond beam into many high-energy micro-spots separated by untreated skin.
Optical breakdown: at each micro-spot the energy is concentrated enough to cause laser-induced optical breakdown, forming tiny cavities inside the epidermis and upper dermis without vaporising the surface.
Repair response: these micro-injuries set off wound-healing signals that prompt fibroblasts to lay down new collagen and elastin over the following weeks.
Depth: the effect is concentrated in the epidermis and upper dermis, shallower than fractional CO2 or RF microneedling.
What tends to respond: shallow boxcar scars, mild rolling texture, enlarged pores and post-inflammatory marks.
What does not: deep icepick scars, rolling scars held down by fibrous bands, and raised hypertrophic or keloid scars.
Pigment risk: because the surface stays largely intact, the risk of post-inflammatory hyperpigmentation is lower than after ablative resurfacing, though not absent.
Course: usually several sessions three to six weeks apart, with change building gradually over months.

Reviewed by Dr Sin Yong, Medical Director, IN Eternity Clinic · Last updated 7 October 2026

Scar types first

Which acne scars do you have?

Acne scars are not one condition. Icepick scars are narrow, deep pits that taper down into the dermis. Boxcar scars are wider, with flat floors and sharp edges, and can be shallow or deep. Rolling scars give the skin a soft, wave-like surface because fibrous bands tether the skin down to deeper tissue. Raised hypertrophic and keloid scars are a different problem again. Most people with acne scarring have a mixture, often alongside red or brown post-acne marks, which are discoloration rather than true scars.

This matters because a tool that suits one type can do almost nothing for another. Any question about whether a laser “works for acne scars” has to be answered scar by scar. The acne scars page explains the types in more detail, and a quick check helps at home: if a scar softens noticeably when you stretch the skin between two fingers, it is more likely rolling; if it stays as a sharp pit, it is more likely icepick or boxcar.

How it works

How does fractional pico remodel acne scars?

A standard picosecond laser spreads its energy evenly across the spot and is designed to break pigment. For scars, a special optic is fitted: a diffractive lens array or microlens array that divides the beam into many tiny points of very high energy, with lower-energy skin in between. Inside each point the energy density is high enough to cause what physicists call laser-induced optical breakdown. A small amount of tissue turns briefly into plasma and forms a microscopic cavity within the epidermis or upper dermis, while the surface above usually stays intact.

Imaging studies using multiphoton microscopy in living human skin have shown these cavities forming inside the epidermis and healing over the following days. The body treats them as tiny wounds and responds with a repair cascade that includes new collagen and elastin. Because the injury is internal and spread out, recovery is short. The trade-off is that each session delivers a modest stimulus at a shallow depth, so change comes from a course of sessions rather than one treatment.

The clinical data reflect that. In a study of facial acne scarring treated with a 755 nm picosecond laser and a diffractive lens array over six sessions, blinded assessment showed improvement in scar appearance, with mild, short-lived side effects. A randomised split-face trial in Asian patients compared a 1064 nm picosecond laser with a diffractive optical element against a non-ablative 1550 nm erbium-glass laser over four sessions and found greater scar improvement on the picosecond side, with less pain and fewer side effects. These studies are encouraging but small, and they mostly involved mild to moderate scarring.

Can and cannot

What can fractional pico do for each scar type?

Scar or concern	Role of fractional pico	Usual main tool
Shallow boxcar scars	Useful; gradual softening of edges	Fractional pico, RF microneedling or CO2
Mild rolling texture	Helps the surface once tethering is released	Subcision, then energy treatment
Deep icepick scars	Little effect on its own	Focal TCA CROSS or punch techniques
Deep boxcar scars	Supporting role only	Fractional CO2 resurfacing
Brown post-acne marks	Useful; the same platform also treats pigment	Pigment laser and topical care
Raised (hypertrophic) scars	Not appropriate	Injection and other scar treatment

In short, fractional pico is a surface and texture tool. It is useful where scars are shallow, where pores and texture coexist with scarring, and where post-acne pigmentation needs treating at the same time. It is the wrong tool for scars that are deep or tethered, and using it alone there tends to give little change for the time and cost.

Compared

How does fractional pico compare with CO2 and RF microneedling?

Fractional CO2 laser removes microscopic columns of skin and heats around them. It gives the strongest remodelling per session, particularly for boxcar scars and sharp scar edges, but brings about a week of redness and fine crusting and a higher risk of post-inflammatory pigmentation in darker skin. RF microneedling delivers heat through fine needles at chosen depths in the dermis, which suits rolling scars and enlarged pores, with a few days of recovery. Fractional pico works shallowest, with the shortest recovery.

For Asian skin the choice also turns on pigment risk and time. Someone who reacts to minor injuries with lasting brown marks, or who cannot take a week away from work, may start with gentler, shallower tools and accept that more sessions will be needed. Someone with deep boxcar scarring and fewer pigment concerns may gain more from fewer, stronger CO2 sessions spaced months apart. Season matters a little too: resurfacing is easier to protect from sun when there is less outdoor travel planned. These are trade-offs to discuss, not rules, and the plan can change as the skin responds.

None of these is a replacement for the others. They work at different depths, and a scar plan often uses two or three of them across several months. The full side-by-side comparison is in CO2 vs RF microneedling vs pico for acne scars.

At IN Eternity Clinic

How are acne scar plans built at IN Eternity Clinic?

Dr Sin Yong first makes sure acne is controlled, because new inflammation makes new scars. He then maps the scars under angled light, noting type, depth and tethering, and photographs them in standard positions. Tethered rolling scars may be released with subcision. Deep icepick scars may be treated individually with focal TCA CROSS. Resurfacing is usually done with fractional CO2 on the DEKA SmartXide Tetra PRO (S3 Resurfacing with SCAR3) or with RF microneedling on CLASSYS Secret Duo.

IN Eternity Clinic’s picosecond platforms are the DEKA TORO and the Fotona StarWalker PQX, which are used mainly for post-acne pigmentation and tone (see pico laser Singapore). Where a plan includes a picosecond step, it is to treat marks, shallow texture or pores alongside the main scar work, not to replace it. Skin-quality injectables are sometimes added between sessions; the guide to skin boosters for acne scars explains where they fit. Dr Sin Yong will tell you which tools he recommends for your scars and why.

Recovery and results

What are recovery and results like?

Fractional pico is done after numbing cream and feels like rapid snapping with some heat. Afterwards the skin is red and slightly swollen for a few hours to a day or two, sometimes with a faint grid of dots and a sandpapery feel as the micro-injuries heal. Most people return to work the next day. Gentle cleansing, a bland moisturiser, no active skincare for about a week and daily sunscreen are the main aftercare.

Results are gradual and partial. Collagen remodelling builds over three to six months after a course, so changes are judged against standardised photographs taken under the same lighting rather than in the bathroom mirror. A realistic aim is softer edges, smoother texture and less shadowing, not skin that looks as though acne never happened. Medicines that affect healing, such as isotretinoin, a prescription medicine for acne, change the timing of any scar procedure and are reviewed first. The broader options are summarised on acne scar treatment.

Myths and facts

Common myths, answered

Myth: Pico laser removes all acne scars.
Fact: Fractional pico softens shallow scars and texture. Deep icepick and tethered rolling scars need other techniques first.
Myth: Pico for scars is the same as pico for pigment.
Fact: Scar treatment uses a lens array to create micro-injuries in the skin; pigment treatment uses an even beam to fragment melanin.
Myth: No crusting means nothing happened.
Fact: Fractional pico works beneath the surface. The change is collagen remodelling over months, not peeling.
Myth: More sessions always mean better results.
Fact: Benefit levels off when the scars are too deep for the tool. A plan that changes technique can do more than repeating the same one.

Questions

Frequently asked questions

Does pico laser work for acne scars?

Fractional picosecond laser can soften shallow boxcar scars, mild rolling texture and enlarged pores, and it treats post-acne pigmentation at the same time. Studies show modest improvement over a course of sessions. It has little effect on deep icepick scars or rolling scars held down by fibrous bands, which need subcision, focal TCA CROSS or fractional CO2 resurfacing.

What is fractional pico laser?

It is a picosecond laser fitted with a diffractive or microlens array that splits the beam into many tiny, high-energy points. Each point creates a microscopic zone of injury inside the skin, called laser-induced optical breakdown, which prompts collagen repair. Because the surface stays largely intact, recovery is short, usually a day or two of redness.

How many sessions of pico laser are needed for acne scars?

Studies have used four to six sessions, spaced roughly three to eight weeks apart, and change continues to build for months afterwards. The number depends on the depth and type of scars and on what else is in your plan. Deeper scars need other techniques, so the pico sessions are planned alongside them rather than on their own.

Is pico laser better than CO2 laser for acne scars?

They do different jobs. Fractional CO2 gives stronger remodelling per session for boxcar scars and sharp edges, with about a week of recovery and a higher pigment risk. Fractional pico is gentler and shallower, with short recovery, and suits mild scarring and texture. Many plans use both at different stages, chosen by scar type.

Is fractional pico safe for darker skin?

It is often chosen for skin that pigments easily, because the surface is largely spared and less heat is involved than with ablative resurfacing. Post-inflammatory hyperpigmentation can still occur, so settings are adjusted for your skin type, sun protection is strict, and a test area may be treated first if you have reacted to procedures before.

Can I have pico laser while I still have acne?

Active acne is usually brought under control before scar treatment, because new inflammation creates new scars and can flare after procedures. Gentle pigment treatment for post-acne marks may be considered once breakouts have settled. If you are taking isotretinoin, a prescription medicine, the timing of any laser procedure is discussed with you first.

How much does pico laser for acne scars cost?

Cost depends on the area, the number of sessions and what else your scars need, such as subcision, focal TCA or fractional CO2. A plan for mild texture is very different from one for deep, mixed scarring. Dr Sin Yong gives a written quote after mapping your scars, and the consultation fee is waived with any medical treatment.

References

Brauer JA, Kazlouskaya V, Alabdulrazzaq H, et al. Use of a Picosecond Pulse Duration Laser With Specialized Optic for Treatment of Facial Acne Scarring. JAMA Dermatol 2015;151(3):278-284. doi:10.1001/jamadermatol.2014.3045
Balu M, Lentsch G, Korta DZ, et al. In vivo multiphoton-microscopy of picosecond-laser-induced optical breakdown in human skin. Lasers Surg Med 2017;49(6):555-562. doi:10.1002/lsm.22655
Kwon HH, Yang SH, Cho YJ, Shin E, Choi M, Bae Y, et al. Comparison of a 1064-nm neodymium-doped yttrium aluminum garnet picosecond laser using a diffractive optical element vs. a nonablative 1550-nm erbium-glass laser for the treatment of facial acne scarring in Asian patients: a 17-week prospective, randomized, split-face, controlled trial. J Eur Acad Dermatol Venereol 2020;34(12):2907-2913. doi:10.1111/jdv.16643
Jacob CI, Dover JS, Kaminer MS. Acne scarring: a classification system and review of treatment options. J Am Acad Dermatol 2001;45(1):109-117. doi:10.1067/mjd.2001.113451
Wu DC, Goldman MP, Wat H, Chan HHL. A Systematic Review of Picosecond Laser in Dermatology: Evidence and Recommendations. Lasers Surg Med 2021;53(1):9-49. doi:10.1002/lsm.23244

These sources describe mechanisms and general evidence. They are not a promise of any individual result; suitability is decided at an in-person assessment.