Ablative CO2 for scars and deeper texture; non-ablative FSX for tone, fine lines and eyelids. At IN Eternity Clinic, a designated DEKA Centre of Excellence, settings are planned around Asian skin.
WhatsApp to Enquire →Key facts ↓A fractional laser treats skin in microscopic columns and leaves the skin between them intact, so healing starts from untouched tissue. Ablative fractional lasers such as the DEKA Tetra Pro CO2 vaporise columns for scars and deeper texture, with about a week of recovery. Non-ablative lasers such as FSX (thulium and erbium glass) heat without removing skin, for texture and tone with lighter recovery.
A fractional laser does not treat the whole surface of the skin at once. It splits the beam into thousands of microscopic columns, each a fraction of a millimetre wide, and leaves bridges of untouched skin between them. Because healthy tissue surrounds every treated column, the skin heals from the sides and from below within days, much faster than after a laser that removes the whole surface.
This idea, called fractional photothermolysis, was described in 2004 and changed resurfacing. Two settings decide what a fractional treatment does: depth, which sets how far each column reaches into the dermis and therefore which problem it can reach, and density, the share of the surface treated in a pass, which drives both the strength of the result and the length of recovery.
Fractional lasers work at wavelengths absorbed by water in the skin. Some vaporise the columns completely (ablative); others heat them without removing tissue (non-ablative). That single difference explains most of what separates them in practice.
| Ablative: DEKA Tetra Pro CO2 | Non-ablative: FSX laser | |
|---|---|---|
| What it does to the skin | Vaporises microscopic columns of skin, with a rim of heat around each | Heats microscopic columns without removing tissue |
| Energy | Carbon dioxide laser, 10,600 nm | Thulium and erbium glass energy in a multi-pass protocol |
| Strength | Stronger change per session; reaches deeper scars | Gentler per session; builds over a course |
| Main uses | Rolling and boxcar acne scars, deep texture, surgical scars | Fine lines, crepey skin, heavy upper eyelids, texture, post-acne redness, superficial scars |
| Typical recovery | About 5–7 days for the surface to heal; pinkness fades over weeks | Redness for hours; light scabs for 3–7 days after stronger passes |
| Usual course | One or a few sessions, months apart, within a scar plan | Usually 3–5 sessions, 4–6 weeks apart |
| Pigment risk in Asian skin | Higher; settings, density and aftercare planned around it | Lower, but not absent; settings chosen per skin type |
Neither type is simply stronger or better. A deep, rolling acne scar needs the reach of an ablative laser, while crepey eyelid skin or dull texture is usually better served by a non-ablative course with less downtime.
IN Eternity Clinic is a designated DEKA Centre of Excellence, and its ablative fractional laser is the DEKA Tetra Pro CO2. For acne scarring it is run as the SCAR3 protocol: precise point-shots into individual scar pits, then a fractional pass over the surrounding skin to blend the edges. Tethered rolling scars are often released by subcision first, and ice-pick scars treated with TCA CROSS, because a laser on its own cannot lift a scar held down by fibrous bands.
The same platform underpins the S3 Resurfacing Lift and the layered 4D Scar Reconstruction protocol. Expect the treated skin to look bronzed and rough for several days as microscopic crusts form and shed, then pink for some weeks. Most people plan about a week away from important events.
FSX laser (Flawless Smooth Skin) is IN Eternity Clinic’s multi-pass protocol using thulium and erbium glass energy. The thulium passes work near the surface on tone and fine texture; the erbium glass passes reach into the dermis to prompt collagen remodelling. Because tissue is heated rather than removed, recovery is short: redness that settles within a couple of hours for most people, and light scabs for a few days after stronger passes.
FSX is used for heavy upper eyelids, fine lines, active acne and post-acne redness, superficial scars and early laxity, usually over three to five sessions four to six weeks apart, with yearly maintenance. Settings are chosen for each skin type, including darker skin, and melasma has its own separate approach.
Fractional laser is not the first choice for melasma, which can darken with heat, or for raised keloid scars, which need a different approach. Active acne is brought under control first; see acne treatment.
“Fractional laser works because most of the skin is left untouched. Treating more of it at once does not heal you faster; in Asian skin it mostly darkens you faster.”
After fractional CO2. Day 0: the skin feels hot and looks red, with fine pinpoint marks in a grid. Days 1–3: swelling, a bronzed, sandpaper look and oozing in places; gentle cleansing and a barrier ointment are used. Days 4–7: fine crusts flake off and the skin underneath is pink. Weeks 2–6: pinkness fades gradually; strict sun protection matters most now, because this is when pigment can rebound.
After FSX. Day 0: warmth and redness for a few hours, sometimes a little swelling around the eyes. Days 1–3: the skin can feel dry and look slightly rough; after stronger passes, light scabs form. Week 1: scabs shed and make-up can usually be worn. Weeks 2–4: collagen remodelling continues quietly before the next session.
With either laser, exfoliating acids and retinoids are paused for the period advised, and sunscreen is non-negotiable throughout.
Most people in Singapore have Fitzpatrick skin types III to V. Their skin responds well to fractional resurfacing but is quick to produce extra pigment after inflammation. Studies of fractional resurfacing in Asian skin link this risk to higher energy and, especially, higher density, so the plan aims for steady change across sessions rather than one aggressive pass.
At IN Eternity Clinic that means density and energy chosen for the skin type, longer intervals between ablative sessions, skin prepared beforehand where appropriate, no treatment over a recent tan, and a clear aftercare plan, including when to report early darkening so it can be treated promptly. Laser for darker skin tones explains the wider approach.
It depends on the laser, the problem and your skin. Non-ablative courses are usually three to five sessions, four to six weeks apart, because each session does less. Ablative CO2 for acne scars is often one to a few sessions spaced months apart, with subcision or TCA CROSS added between them as needed. Scars are reassessed against baseline photographs before each session, and the plan is changed if the response is slower or faster than expected.
Cost depends on whether the laser is ablative or non-ablative, the area treated, the number of sessions and whether other steps such as subcision, TCA CROSS or an injectable are part of the plan. Because acne scarring in particular varies so much between people, the plan and its cost are set out after assessment at IN Eternity Clinic, and the consultation fee is waived with any medical treatment. Further detail is in acne scar treatment cost.
Treatment is postponed over active acne, infection or cold sores, on recently tanned skin, during pregnancy, and in some people with a history of keloid scarring. After oral acne tablets, timing is discussed individually; see laser after acne tablets. People prone to cold sores may be given preventive medicine before treatment around the mouth. Your medical history and current skincare are reviewed first.
Fractional CO2 is one kind of fractional laser: the ablative kind, which vaporises microscopic columns of skin. Fractional laser also includes non-ablative lasers such as thulium and erbium glass, which heat columns without removing tissue and need less recovery.
Deeper rolling and boxcar scars usually need the reach of fractional CO2, often with subcision or TCA CROSS. FSX suits superficial scars, post-acne redness and texture with less downtime. Many plans use both at different stages.
After fractional CO2, the surface usually takes about five to seven days to heal, with pinkness fading over weeks. After FSX, redness usually settles within hours, with light scabs for a few days after stronger passes.
It can be used in Asian and darker skin when settings, density and intervals are chosen for the skin type and aftercare is strict. The main risk is post-inflammatory hyperpigmentation, which is planned for and treated early if it appears.
Numbing cream is applied beforehand. Fractional CO2 feels like hot prickling and the face feels sunburnt for a few hours afterwards. FSX feels warm and prickly during passes. Cooling and pacing keep both manageable.
It can help pores that look large because collagen support around them has thinned or because of acne scarring. It does less for pores stretched mainly by oil, which respond better to oil control, peels or laser toning.
Both prompt new collagen. Fractional laser acts through light absorbed by water, while RF microneedling delivers radiofrequency heat through fine needles at a chosen depth, with less surface injury. The choice depends on scar type, skin type and how much downtime you can take.
IN Eternity Clinic, 9 Scotts Road, #12-01 Pacific Plaza, Singapore 228210. By appointment with Medical Director Dr Sin Yong. Monday to Saturday, 11am to 8pm. WhatsApp or call +65 8815 3008. The consultation fee is waived with any medical treatment.
These sources describe mechanisms and general evidence. They are not a promise of any individual result; suitability is decided at an in-person assessment.