The short answer
Acne can leave two kinds of problem. Marks are a change in colour. Scars are a change in contour. Pico laser works on some marks and on shallow texture, so the first task is to work out which you have.
Most deeper scars need a different step, and sometimes pico has no role at all. Dr Sin Yong assesses each scar type and treats personally. The wider plan is covered in the acne scar guide.
Two ways the laser is used
For brown marks. It uses low energy, a large spot and a long interval. A mark that darkens is reviewed, not retreated.
For shallow texture. A diffractive optic concentrates energy into small points, making microscopic cavities in the epidermis and upper dermis. Texture work is staged, and comes after any subcision or CO2 steps.
What pico laser for acne scars can and cannot reach
| Concern | Role of pico | What it needs instead |
|---|---|---|
| Brown marks after acne | May help | Acne control first |
| Fine rolling scars, early boxcar edges, rough surface | May help | Staged texture work |
| Red or pink marks | Not a target | A vascular-directed laser or R2 Glow |
| Tethered rolling scars | Cannot release | Subcision |
| Deep boxcar walls | Does not reach | Fractional CO2 or other steps |
| Ice-pick tracts | Does not reach | TCA CROSS first |
Who should wait
Inflamed acne is controlled first. Marks keep forming while acne is active, so acne treatment comes before scar work.
Treatment is deferred while the risk of darkening is high, such as during sun exposure.
The skin is allowed to recover first.
These need conservative settings, and a small test area may be treated first.
Risks and side effects
Post-inflammatory darkening is the main risk in Fitzpatrick III to V skin. Picking at fine crusts and sun during healing raise the chance of brown marks.
Pale, mottled spots can follow toning repeated too often.
Pinpoint bleeding, prolonged redness, an acne flare, or a cold sore outbreak around the mouth.
Increasing pain, swelling, pus or dusky skin.
How it differs from fractional CO2
Fractional CO2, used in the S3 Resurfacing Lift, vaporises columns of tissue and reaches deeper than fractional pico. So it is named as a separate option for deeper scar edges. It is not an interchangeable choice. Pico texture work is planned for what is shallow and left to the end, once any subcision or CO2 steps are complete. If a surface laser is used on a tethered scar, the pull stays in place, so the order of steps matters as much as the device.
Recovery
Expect pinpoint redness, mild swelling and a rough or sandpapery feel, then fine flaking. How long this lasts varies with the settings and your skin. Downtime is lighter than with ablative lasers, but there is still a recovery period. Keep the skin out of the sun and leave any crusts alone. Written aftercare is given on the day, and the pico laser aftercare page has more detail.
Sessions and fees
There is no fixed session count or interval. Plans are staged, and each step is reviewed before the next. Fees are set in writing after assessment. They depend on the scar types present, the steps needed and their order, the area treated and how the plan is staged. No prices are listed, as Singapore's rules prevent them from being advertised. An assessment may end with advice to use a different tool. You can book a consultation to have your scars mapped.