pico fractional laser acne scars

Fractional PICO LASER Acne Scars

Fractional PICO laser is FDA-approved for acne scar resurfacing.  The picosecond laser is fractionated via a variety of diffractive lens array. This fractionation approach concentrates the laser energy into microbeams while limiting damage to the surrounding skin. The absorption of microthermal energy within your skin initiates a plasma reaction and a cascade of healing events. It resurfaces your skin from within by stimulating collagen growth, elastin formation and dermal remodelling. Demonstrating a high degree of safety, tolerability and efficacy, the fractional pico laser for acne scars is safe for all skin types.  

Tanghetti, E.A. et al. (2016)

Is Fractional PICO Laser treatments suitable for all acne scar types?

It really depends. Your acne scar treatment plan must take into account the acne scar morphology, scar depth, surrounding skin condition, medical history and past treatment histories. In most cases, where acne scars are a mixed type, we may recommend procedures such as TCA CROSS, subcision, fillers and/or lasers and energy based devices. There is not a single modality or device that will treat all types of mix acne scarring.

However, for individuals with mild to moderate atrophic acne scarring where the desire for low downtime is more socially acceptable, fractional picosecond laser treatment is an option.

Fractional pico laser treatment for acne scars is also suitable for darker skin phototypes IV to VI. The unwanted risks of post-inflammatory hyperpigmentation (PIH) is mitigated by fractionated microbeams that causes little surrounding tissue damage.

Cavities (red arrows) from Laser induced optical breakdown

How does Fractional PICO Laser for Acne Scars Work?

Picosecond laser treatments emit high laser power and ultra short laser pulses (450 picosecond). Did you know that a picosecond is a trillionth of a second? These ultra short pulses create a photomechanical (or photoacoustic) effect without heating up too much of the surrounding skin (photothermal effect). This is reduces downtime and scarring post procedure, and is safer in darker skin types.

Fractional pico laser treatments allow higher peak energies to be concentrated on laser micro-beams (diffractive lens array), thus minimising collateral damage. The tissue effects centers on a phenomenon known as Laser Induced Optical Breakdown (LIOB).  Basically, optical breakdown of  dermal tissue creates small cavities underneath the skin, whereupon natural healing responds by stimulating new collagen and elastin formation. 

Atrophic acne scars are the consequence of loss of collagen underneath the skin. Fractional pico lasers for acne scars deliver ultra short pulses beneath the skin to stimulate collagen and elastin, without compromising the outermost skin layer (the stratum corneum). Transformation, regeneration and strengthening of your skin begins from within!

Fractional Picosecond Laser Difference:

Mixed Atrophic Acne Scars

Systemic Review of Picosecond Laser for Acne Scars

Wu D.C. et al (2021)

A literature review of a case series, retrospective reviews, clinical trials and a randomized comparision trial show fractional picosecond lasers to be safe and effective for mild to moderate acne scarring. Individuals with darker skin type are better candidates for treatment due to the lower risk of post-inflammatory hyperpigmentation.

How long is the recovery time for Fractional PICO Laser for Acne Scars?

Common post procedure effects include temporary redness, swelling, itchiness, dryness, acne, small pin point bleeding and tingling. Post-inflammatory hyperpigmentation (PIH) with fractional pico lasers is significantly lower when compared to fractional CO2 laser treatments.

Although recovery in most instances is within a week you may experience a longer recovery when more intense treatment is needed.

Who is not suitable for treatment?

Are Pico laser treatments painful?

Most treatments are tolerated well. A tingling sensation is commonly felt. We use numbing cream prior to your treatment to maximise comfort and experience.

How soon can I see results?

For acne scar resurfacing, wound healing occurs within weeks after your first treatment. Collagen and elastin fibers continue to form and restructure months later. The improve of acne scar appearance continues months after your fractional pico laser treatment.

How many Fractional PICO Laser sessions are needed?

For mild to moderate acne scarring, we recommend an average of 4 fractional pico laser sessions. Treatments are carried out at intervals of 4-6 weeks.

How do I take care of my skin after treatment?

A gentle cleanser and moisturizers are advisable to keep skin clean and hydrated. You may be prescribed a topical antibiotic to minimize the risk of infections. Stay away from direct and prolonged sunlight, and protect yourself by using a sunscreen (SPF 50 and PA+++).

Avoid exfoliants, AHA/BHA and retinoids for at least one week after your procedure to avoid unwanted skin irritation.

Can Fractional Picosecond Laser be used for other scars?

Although the clinical data remains limited, there are a number and emerging reports of the utility of fractional pico lasers for non-acne scar types. These may include hyperpigmented scars post-burns, surgery or trauma. In addition, there may be benefits in the treatment of atrophic, hypertrophic scars and striae alba (stretch marks).

It is important to talk to your doctor regarding off-label treatments in order to assess your suitability for the procedure.

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References:

  1. Bernstein EF, Schomacker KT, Basilavecchio LD, Plugis JM, Bhawalkar JD. Treatment of acne scarring with a novel fractionated, dual wavelength, picosecond domain laser in-corporating a novel holographic beam splitter. Lasers SurgMed 2017;49(9):796–
  2. 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–
  3. Chayavichitsilp P, Limtong P, Triyangkulsri K, Pratumchart N. Comparison of fractional neodymium doped yttrium aluminum garnet (Nd:YAG) 1064nm picosecond laser and fractional 1550nm erbium fiber laser in facial acne scar treatment. Lasers Med Sci 2019;35:695–Tanghetti, E.A. (2016), The histology of skin treated with a picosecond alexandrite laser and a fractional lens array. Lasers Surg. Med., 48: 646-652. https://doi.org/10.1002/lsm.22540
  4. Yang CS, Huang YL, Cheng CY, Hu S, Chang SL, Lee MC. A prospective study of fractionated dualwavelength pico-second laser in treating acne scar. Lasers Surg Med 2020. https://doi.org/10.1002/lsm.23218.
  5. Wu, D.C., Goldman, M.P., Wat, H. and Chan, H.H. (2021), A Systematic Review of Picosecond Laser in Dermatology: Evidence and Recommendations. Lasers Surg Med, 53: 9-49. https://doi.org/10.1002/lsm.23244
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