Acne scars are one of the most common long-term concerns faced by patients after breakouts. While topical creams and home remedies can offer limited improvement, many scars require medical treatments to remodel collagen and restore skin texture. Laser treatments have become a key option because they target both the texture and pigmentation issues left behind by acne.
Two commonly used laser treatments are the non-ablative fractional laser and the picosecond laser. Each works differently, and choosing between them can affect recovery, cost, and overall results.
At Sozo Clinic, treatment plans are tailored based on scar type, skin tone, and patient preferences, a process overseen by medical doctors such as Dr Justin Boey, who manages acne scar treatments as part of his clinical practice.
This article explains how these treatments work, their benefits and limitations, and how to decide which one may be most appropriate for your scar type, skin tone, and lifestyle.
Understanding Acne Scars and Their Treatment Needs
Acne scars form when breakouts damage the skin’s deeper layers, leading to lasting changes in texture and tone. The most common types include:
- Ice pick scars: Narrow and deep, often hard to treat.
- Rolling scars: Broad with sloping edges, creating a wave-like appearance.
- Boxcar scars: Wider depressions with sharp edges.
Laser treatments are commonly selected to stimulate collagen activity, a key protein in the skin’s natural repair process. These treatments can improve overall skin appearance by targeting irregular texture and uneven tone.
The aim is to improve the appearance of skin texture, pigmentation, and tone over time. Outcomes can still vary based on individual skin type and treatment suitability.
What Is a Non-Ablative Fractional Laser?
Non-ablative fractional lasers deliver controlled heat into the dermis through microthermal zones without removing the skin’s surface layer. This process activates the body’s natural healing response and supports collagen remodelling over time. Because the outer layer remains intact, recovery is generally quicker than with fully ablative options.
Suitability and Expected Benefits
- Suitable for Fitzpatrick skin types I–IV
- Often used for atrophic scars, particularly those of the rolling or boxcar type.
- May be suitable for individuals who prefer gradual results with minimal downtime
- Used in treating moderate to deep acne scars
- Can support improvements in skin texture over multiple sessions
- Treatment settings can be adjusted to suit different skin types and scar depths.
What to Expect After Treatment
- Temporary redness, swelling, or mild crusting may occur.
- Patients often experience moderate discomfort during the procedure.
- Recovery usually takes one to three days, depending on skin sensitivity and treatment intensity.
What Is a Picosecond Laser?
Pico lasers offer an alternative approach to treating acne scars, particularly when pigmentation is present or when a shorter recovery time is preferred. These devices deliver energy in extremely short bursts, typically between 300 to 900 picoseconds (one trillionth of a second).
Unlike heat-based lasers, picosecond lasers use photomechanical action. The rapid pulses generate a process known as optical breakdown, which creates controlled disruption in the skin.
This action is designed to:
- Break down pigment particles
- Support collagen and elastin activity.
- Minimise thermal impact on surrounding tissue
Because less heat is used, the surrounding skin remains relatively unaffected. This may help reduce the likelihood of post-inflammatory hyperpigmentation (PIH), particularly in individuals with darker skin tones.
Suitability and Expected Benefits
- This treatment is often used for mild to moderate acne scarring.
- It is suitable for individuals with Fitzpatrick skin types IV–VI.
- It may be preferred by patients who want minimal downtime and gradual improvement.
- Most patients experience minimal downtime, with many resuming activities within a day or two.
- The treatment is generally well tolerated, although individual responses may vary.
- It carries a lower risk of pigmentation changes in darker skin types because of its reduced thermal profile.
- It is designed to target pigmentation and superficial textural irregularities.
Possible Limitations:
- May not be suitable for deeper scars such as ice pick or boxcar types
- Often requires multiple sessions for improvement in atrophic scarring.
- Long-term data is still being established compared to other modalities.
Non-Ablative Fractional vs Picosecond Lasers Comparison
| Feature | Non-Ablative Fractional Laser | Picosecond Laser |
|---|---|---|
| Pulse Duration | 600–1500 microseconds | 300–900 picoseconds |
| Downtime | 1–3 days | 1–2 days |
| Best For | Deeper scars, lighter skin | Darker skin, faster healing |
| PIH Risk (Fitzpatrick V–VI) | Moderate | Low |
| Cost per Session (Est.) | Higher | Moderate |
Recovery Expectations and Post-Treatment Care
Understanding what to expect after laser treatment can help you prepare for the recovery process and manage your skincare appropriately.
With non-ablative fractional lasers, redness and swelling may persist for up to 72 hours, sometimes accompanied by light crusting as the skin renews. In contrast, picosecond lasers tend to cause less downtime, with most effects subsiding within 24 to 48 hours.
What to Expect
After non-ablative fractional or picosecond laser treatments, it’s common to experience:
- Redness similar to a mild sunburn
- Mild swelling that typically resolves within a few days
- A warm or tight sensation in the treated area
With non-ablative fractional lasers, these effects may last up to 72 hours and occasionally involve light crusting as the skin renews. Recovery after picosecond laser treatment is usually shorter, with effects often settling within 24 to 48 hours. Healing time varies depending on skin sensitivity and the treatment settings used.
Post-Treatment Skincare
Following a tailored post-treatment skincare routine may help support healing and reduce the risk of irritation:
- Apply a broad-spectrum sunscreen (SPF 50+) daily to protect healing skin
- Use a gentle moisturiser to maintain hydration and support skin barrier repair.
- Avoid harsh skincare products, such as exfoliating acids or retinoids, for 3–5 days or until your skin has fully recovered.
- Refrain from picking or scratching at peeling or flaking areas to prevent irritation or pigmentation changes.
Reducing PIH Risk
Post-inflammatory hyperpigmentation (PIH) is a risk, particularly for individuals with Fitzpatrick skin types IV–VI. To minimise it:
- Stay out of the sun for at least 1–2 weeks post-treatment
- Keep the skin moisturised to avoid irritation.
- Follow all aftercare instructions provided by your doctor, including any prescribed topical treatments.
Cost Breakdown: Picosecond vs Non-Ablative Laser
The table below offers an estimate of what you might expect when comparing picosecond and non-ablative fractional laser treatments.
| Treatment | Estimated Cost |
|---|---|
| Non-Ablative Fractional | From $450 |
| Picosecond | From $150 – $800 |
What Affects the Price?
- Type of laser machine (brand and technology used)
- Clinic location and setup
- Doctor’s qualifications
- Number of sessions required, based on scar severity and skin response
A proper assessment by your doctor will help determine the most appropriate and cost-efficient approach for your needs.
Choosing the Right Laser for Your Acne Scars
The ideal laser treatment depends on factors such as the type of acne scars, your skin tone, and the amount of recovery time you can manage. Understanding these considerations can help guide your consultation and treatment planning.
Consider Your Scar Type
The table below outlines how different scar types may respond to various treatment approaches. Still, a full skin assessment by your doctor is essential for personalising your care safely and effectively.
| Scar Type | Recommended Laser |
|---|---|
| Ice Pick | May benefit more from non-laser options (e.g., TCA CROSS) |
| Rolling | Non-Ablative Fractional Laser |
| Boxcar | Non-Ablative Fractional Laser |
| Superficial Pigment & Texture | Picosecond Laser |
| Mixed (e.g., texture + pigment) | Combination or tailored approach |
Consider Your Skin Tone
Skin tone can influence how the skin responds to different laser types. Using the Fitzpatrick scale:
- Fitzpatrick I–III (fair to light brown): Generally suitable for a wider range of laser options
- Fitzpatrick IV–VI (medium to deeper tones): Picosecond lasers may be considered due to their lower thermal profile, which may help reduce the likelihood of post-inflammatory hyperpigmentation (PIH)
Always consult a doctor to assess your skin type and sensitivity before starting treatment. Settings should be tailored to your individual needs.
Consider Your Recovery Tolerance
Your schedule and lifestyle may influence which treatment feels more manageable:
- Non-Ablative Fractional Laser: Typically involves 1–3 days of recovery, which may suit those who can accommodate some downtime
- Picosecond Laser: Generally associated with shorter recovery periods, and may be suitable for individuals with limited flexibility or upcoming social commitments
FAQs on Acne Scar Laser Treatments
How long do Laser treatment results last?
Results are generally long-lasting, especially when supported with a good skincare routine. Collagen remodelling continues for several months post-treatment, though some patients may opt for maintenance sessions annually.
Can both lasers (Non-Ablative Fractional vs Picosecond) be combined?
Yes, doctors may combine picosecond and non-ablative fractional lasers in a treatment plan to address different layers of the skin, targeting both texture and pigmentation for more comprehensive improvement.
Are touch-up sessions needed?
Touch-up sessions may be recommended depending on how your skin responds and the depth of your scars. These help maintain results over time.
Can acne scar lasers exacerbate scars?
When performed by a qualified doctor, worsening of scars is rare. However, inadequate aftercare, such as excessive sun exposure or skin picking, can lead to complications.
How to Maximise Results and Safety
Your choices before and after laser treatment can significantly impact your recovery and results. By taking a few simple precautions and following medical advice, you can help your skin heal well and lower the risk of complications.
- Seek treatment from a board-certified doctor with accredited training in aesthetic laser procedures.
- Minimise sun exposure for 1–2 weeks before and after treatment to reduce the risk of pigmentation issues, especially in darker skin types.
- Follow all post-treatment instructions carefully, including any prescribed skincare or medications, to support recovery and minimise the risk of side effects or complications.
- Attend follow-up appointments if advised, as ongoing evaluation may help guide treatment adjustments based on your skin’s response.
Which Treatment Delivers the Best Value?
Everyone’s skin responds differently to laser treatments. Factors such as scar depth, skin tone, and post-treatment expectations influence which approach may be most suitable.
- Non-ablative fractional lasers are often chosen for treating deeper scarring, where stimulating collagen over time is the primary focus.
- Picosecond lasers may be considered when pigmentation sensitivity or shorter recovery time is a priority.
- In cases involving both textural and pigment concerns, a personalised or combination approach may offer a more comprehensive solution.
Your treatment plan and the overall value of the approach will depend on clinical assessment, your skin’s response, and long-term goals.
Planning Your Acne Scar Treatment Journey
Both non-ablative fractional lasers and picosecond lasers play valuable roles in acne scar management. The most suitable treatment depends on your scar type, skin tone, recovery tolerance, and long-term goals. In some cases, doctors may recommend combining different approaches to address both textural and pigment-related concerns.
At Sozo Clinic, our doctors personalise acne scar treatment plans after a detailed assessment of each patient’s skin. By tailoring the choice of laser and session schedule, we aim to achieve natural, progressive improvements in both skin texture and pigmentation.
