Picosecond lasers (Pico) and fractional CO₂ target skin very differently.
If your goal is to improve acne scars (texture) rather than pigmentation, here’s how each device fits—and what realistic outcomes look like.
Why This Comparison Matters
Many patients ask for “Pico” after seeing pigmentation results online. But for textural, atrophic acne scars (rolling, boxcar, ice-pick), treatment usually requires controlled injury and collagen remodelling deeper in the dermis—something fractional CO₂ laser was designed to do.
Pico can play a role in select situations, but expectations should be calibrated. Find out the difference in pico vs CO2 acne scar laser.
Start with a personalised plan: acne-scar removal timeline in Singapore. Also see our overview: Laser Treatment for Acne Scars.
How They Work (Texture, Not Pigment)
| Parameter | Picosecond Laser (Pico) | Fractional CO₂ Laser |
|---|---|---|
| Energy/Action | Ultra-short pulses; mainly photoacoustic effects, micro-lattice LIOB* in superficial layers | Ablative micro-columns (MTZ) that resurface & stimulate robust collagen remodelling |
| Primary Strength | Pigment & fine textural refinement; pore/toning support | Textural acne scars (rolling/boxcar) and mixed scars; structural change |
| Depth/Intensity | More superficial to mid-dermis; gentler structural impact | Superficial to mid-dermis with controlled ablation; stronger remodelling |
| Downtime | Low (redness, mild flaking) | Moderate (3–7 days redness/micro-crust), tailored by settings |
| Best Use-Case (Scars) | Mild textural roughness; maintenance between stronger sessions | Mild–severe atrophic scars; cornerstone for structural improvement |
| Role in a Plan | Adjunct for tone/pores or gentle texture; expectation management essential | Lead modality for resurfacing; can combine with subcision/biostimulators |
*LIOB = Laser-Induced Optical Breakdown micro-injury patterns associated with picosecond devices.
Myth vs Fact: Pico for Acne Scars
| Myth | Fact |
|---|---|
| “Pico removes deep acne scars like CO₂.” | Pico refines texture but typically does not replace fractional CO₂ for structural remodelling in rolling/boxcar scars. |
| “Pico is always safer than CO₂.” | Safety depends on settings, technique, and skin type. CO₂ can be very safe when conservatively parameterised; Pico can still cause PIH if misused. |
| “If I’m sensitive to downtime, Pico is the only option.” | Pico has less downtime, but improvement for scars is usually smaller per session. Fewer, well-timed CO₂ sessions may reach goals faster overall. |
| “CO₂ is just for severe scars.” | CO₂ can be titrated (density/fluence/pulse) for mild to severe scars and combined with subcision when tethering exists. |
Setting Expectations by Scar Type
- Rolling/Boxcar (atrophic): Expect CO₂ (often the workhorse) ± subcision; Pico may add tone/pore finetuning but is not the main driver of structural change.
- Ice-pick: Often need TCA CROSS or punch techniques before resurfacing; neither Pico nor CO₂ alone is a silver bullet.
- Mixed scars: Layered plan (subcision → CO₂ → adjuncts like Rejuran S or RF) achieves more predictable gains.
Frequently Asked Questions
Does Pico laser remove acne scars?
Pico can help with pigment and mild texture, but for true atrophic scars it’s usually an adjunct. Structural remodelling generally relies on fractional CO₂ laser, sometimes paired with subcision.
Why choose CO₂ over Pico for scars?
Fractional CO₂ creates controlled ablation columns that trigger stronger collagen remodelling and visible texture change. That is why CO₂ is often selected as the primary scars modality, with Pico reserved for finishing or pigment-adjacent goals.
Can both be combined?
Yes. Some plans sequence CO₂ for structure, then use Pico later for tone/refinement—particularly helpful if pigmentation accompanies scarring. Spacing is tailored to healing and skin type.
What to Do Next
Match the tool to the job: use CO₂ when the priority is texture change, consider Pico for tone and fine refinement. Your plan should account for scar type, downtime tolerance, and skin tone.
- Map your plan: plan your acne-scar removal timeline
- Read: Laser Treatment for Acne Scars (explainer)
- Learn about Fractional CO₂ Laser for Scars
Educational content only; not a substitute for medical advice. Suitability, downtime, and results vary.
