2021 Guide to Fractional CO2 Laser for Acne Scar Removal

fractional laser acne scar removal

Very few people are blessed with a non-greasy, acne-free skin. For the rest of us, the battle with acne and scars begins right in our teens. Fortunately, modern science provides us with lasers (Light Amplification by Stimulated Radiation Emission), a safe and efficient tool to fight against pimples and scars. Lasers such as the pico laser and fractional laser for acne scar removal provide light impulses which:

  1. kill acne-causing bacteria and reduce inflammation in case of active pimples.
  2. break down and remove the superficial scarred skin layers and stimulate the growth of new, healthy tissues to replace the scarred ones.

The magic of laser is not restricted to acne alone, they are equally effective in treating a myriad of skin imperfections including:

  • Signs of aging
  • Traumatic scars
  • Uneven skin tone and texture
  • Enlarged pores
  • Sun damage and melasma
  • Warts, etc.

Fractional CO2 Laser for Acne Scar Removal

Of the several laser treatments available, fractional CO2 laser serve as a gold standard solution for stubborn acne scars. Also known as laser peel or lasabrasion, this FDA-approved, non-invasive, non-surgical procedure uses CO2-powered laser beams to get you on the road towards a scar-free complexion.

CO2-powered laser beams for skin

What to expect during treatment

A half hour prior to the treatment, a local anaesthetic cream is applied over the area to be addressed. This is to reduce any slight pain, prickling, burning sensation or discomfort during the procedure.

The fractional lasers induce thousands of microthermal holes or columns in the skin, which reach the dermis beneath the scarred area, leaving bridges of intact skin in between to help with fast healing.

This laser beam generates a heating effect encouraging new collagen formation and remodelling of the existing tissues. The new tissue then fills up the gap and pushes up the indented scars, making them flatter and level up to blend naturally with the surrounding skin.

Types of fractional resurfacing

types of fractional resurfacing devices

There are two types of fractional resurfacing, and these include:

  • Ablative: Here, the laser exfoliates the superficial damaged skin layer, exposing the healthy layer beneath and followed by the heat-induced collagen regeneration. Used for deeper, intense scars with associated damage or discoloration.
  • Non-ablative: Only collagen synthesis and remodelling occur, and there is no removal of surface tissue. Treats 60-70% of all acne scars.

Based on the size, depth, skin type and associated conditions such as pigmentation or damage, an aesthetic doctor can help you decide whether to go for ablative or non-ablative fractional CO2 resurfacing.

Do fractional lasers work on any acne scar?

It can work on almost any type of acne scar. The most common types are:

  • atrophic scars (mostly near to the surface)
  • boxcar scars (rectangular depressions with sharp clear edges)
  • rolling scars (rectangular depressions with poorly defined edges)
  • ice pick scars (narrow, pointed, deep, steep)
  • hypertrophic scars (raised above skin surface mostly due to cystic/nodular acne)

By enhancing collagen synthesis, fractional CO2 lasers raise the depressions evenly, making it a treatment of choice for atrophic, boxcar, rolling and combination scars.

which acne scar for fractional laser

What other skin conditions can fractional lasers target?

  • Ageing or matured skin

With age, the collagen fibres located in the dermis decrease in number and even get disorganized. This leads to loss of skin firmness and development of wrinkles and creases.

Laser beams destroy the superficial layer of skin thereby removing the existing wrinkles and creases. Furthermore, the laser stimulates new collagen synthesis to rejuvenate and tighten the skin. This helps in preventing the development of newer signs of aging.

  • Pigmentation, Sun-damaged and dull skin

Lasers ablate the superficial pigmented skin and remove the dull or dead skin cells. Later, this gets replaced by a healthier glowing rejuvenated skin, thanks to the collagen neogenesis.

These beams also penetrate the deeper skin layers and specifically address the light absorbing molecules called chromophores situated in there. Moreover, along with the collagen remodelling, lasers simultaneously remove the melanin pigment from the upper layers of the skin, thereby evening and brightening the overall skin.

In short, fractionated CO2 skin resurfacing lasers can diminish your scars and make your skin look younger, brighter and firmer too.

other skin conditions for fractional laser

Things to note about fractional laser for acne scar removal

Here is an easy checklist to summarise all there is to know about removing acne scars with fractional CO2 laser.

  • The entire process takes around 15 to 20 minutes.
  • Skin remains warm and appears red and puffy for 1 to 3 hours after the procedure.
  • Skin looks like sun-burnt and multiple microscopic, tiny crusts develop over the treated area in the next 2 days.
  • Crusts eventually fall off on their own and significant improvement can be noticed after 5 to 7 days.
  • Once completely healed, the skin looks healthier, smoother, fresher and illuminated. This effect stays for 4 to 6 months as the new collagen continues to grow.

How do you care for the skin after a fractional resurfacing?

As with every facial treatment, aftercare is as important as the treatment itself. It helps maintain the results and keep it for longer, and ensure that the skin receives the help it needs to heal well.

Fractional laser treatments for acne scar removal may cause the affected skin to turn dry and crusty. Therefore the most important thing to remember in the aftercare routine is to curb your instinct to pick at or scratch the scabs formed (if any).

fractional laser aftercare tips

Other aftercare tips for fractional resurfacing include:

  • Apply antibiotic cream and recovery creams recommended by the doctor to avoid impending infections and speed up recovery.
  • Use cool compresses (not ice packs) or aloe gels if any inflammation persists.
  • Use gentle cleansers to clean the face.
  • Avoid exfoliators or scrubs.
  • Apply hypoallergic moisturizers twice daily.
  • Sun-protection is important. Use sunscreens with a minimum of 50+ SPF.
  • Limit make-up to minimal for at least a week.
  • Refrain from creams containing irritants like AHA, retinoids, etc to prevent further skin irritation.
  • Avoid situations, such as swimming and heavy workouts, where you can get an infection.

Fractional VS Traditional skin resurfacing

Though the principle for both techniques is the same, their mode of application differs and hence resulting in varying outcomes.


Traditional skin resurfacing

Fractional skin resurfacing

Mode of application

Targets entire area in single setting and continuous manner.

Multiple smaller laser beams ablate skin in smaller spots with healthy areas in between.

Site of Action

Ablative lasers- predominantly target epidermis

Non-ablative- solely targets dermis.

Works at both the epidermal and dermal layers of the skin.


Single setting solution

Healthy areas in between facilitate rapid healing and prevent complications like infections.


Larger post-treatment burnt-out area takes more time to heal increasing the risk of infections.

Multiple settings needed.

What are the costs involved for each?

The price for fractional laser for acne scar removal depends on the number, site, size and severity of scars, as well as the number of sessions needed. Your dermatologist or aesthetic doctor is well-equipped to discuss the treatment plan with you to achieve clear, blemish-free skin.

dermatologist checking acne scar

On average, an acne scar treatment with ablative fractional CO2 resurfacing laser in Singapore can cost around $300 – $1,200 per session. In contrast, non-ablative fractional CO2 resurfacing laser treatments cost up to $1,500 per session.

Check out our other blogpost to find out the different costs for all types of laser treatments for acne scars in Singapore.

Which is better suited for acne scar removal?

Though multiple settings can be tiring, a risk of infection is the last thing we want to happen. Plus, the added advantage of targeting both dermis and epidermis at the same time shift our (unanimous) vote towards fractional CO2 lasers!

However, no one shoe fits all. Depending on the severity of your skin condition, traditional lasers may have an advantage over the fractional laser.

Where can I find the best fractional CO2 laser treatment in Singapore?

Ablative and non-ablative skin treatments can have great results for acne scars, but it is not without its risks and side effects. Laser treatments should always be handled by a professional, and it is advisable to seek accredited and MOH-approved clinics – ones that offer accessible costs.

Looking for an aesthetic doctor for your acne scars? Schedule an appointment with any doctor on our list of aesthetic doctors in Singapore to find one that is compatible with you.