Main guideAcne scar treatment Singapore — what it treats, who it suits, sessions, downtime and what decides the cost, by Dr Sin Yong.
Published 31 October 2026 · Reviewed by Dr Sin Yong
You are likely to be suitable for fractional CO2 laser when you have boxcar or shallow rolling acne scars, acne is under control, your skin is healthy on the day, and you can accept a visible healing period. Active acne, infection, a cold sore, pregnancy or a fresh tan defer it. Dr Sin Yong maps the scars and takes a medical history before any laser is chosen.
Short answerFractional CO2 at 10,600 nm vaporises fine columns of skin and leaves bridges of untouched skin to heal from. It creates a controlled wound on purpose, so suitability is about how your skin heals and pigments as much as about the scars. This page sits under CO2 laser in Singapore.
Fractional CO2 suits scars that have walls and floors to rebuild. At the clinic on Orchard Road, Singapore, Dr Sin Yong runs it on the DEKA SmartXide Tetra Pro within the S3 Resurfacing Lift, his protocol for deep acne scars, and the platform's Pulse Shape Design lets him choose how each pulse rises, dwells and tails off to match the scar in front of him.
Illustrative image — not a patient.
The scars that suit it are boxcar scars and shallow rolling scars, on skin where acne has been brought under control. Where a scar is tethered, or narrow and deep like an ice-pick tract, it is released or treated at its floor first, with subcision or TCA CROSS, so that the laser resurfaces skin that is free to remodel. Superficial scars and texture change often suit the non-ablative FSX Laser instead, because a superficial scar does not earn an ablative wound.
The other part of suitability is the healing. Fractional CO2 is ablative, so redness, swelling, pinpoint bleeding, oozing, crusting and peeling are part of the treatment rather than complications. A candidate is someone who can accept that visible phase and follow the wound care and sun protection that go with it. The same platform is also used as a focused beam to remove small benign growths, once each has been examined.
Which scars and which skin: where fractional CO2 fits
What the examination finds
Fractional CO2?
What is used first, instead or alongside
Deep boxcar scars
Yes, within the S3 Resurfacing Lift
Point shots into each box before fractional passes across the skin around it
Shallow rolling scars
Yes, after release
Subcision first, because a laser cannot cut a tethering band
Ice-pick tracts
For the surrounding texture
TCA CROSS into each tract first
Superficial scars and texture change
Often not
The FSX Laser, which leaves the surface intact
Small benign growths: syringoma, a broad-based skin tag, a confirmed benign raised mole
Yes, as a focused beam
Diagnosis first; anything atypical is excised for histology
Brown spots, melasma or redness
No
Pico laser, R2T2 or medical treatment, after diagnosis
Raised, keloid-prone scars
No
Dermatology assessment
Darker skin is not excluded. In Fitzpatrick III to V skin, temporary darkening after resurfacing, post-inflammatory hyperpigmentation, is the main risk, so density, depth and spacing are planned around it. A 2017 review of fractional resurfacing in Asian patients concluded that lower-density settings with wider intervals between treatments carried the lowest risk of that darkening. A 2017 retrospective study from the National Skin Centre in Singapore, covering 210 fractional CO2 treatments for acne scars in 107 patients of Fitzpatrick types II to V, recorded adverse events in 16 patients, most often hyperpigmentation.
“Depth decides the laser. A superficial scar does not earn an ablative wound, and a deep one is not fixed by a gentle pass.”
Dr Sin YongOn who suits fractional CO2
Who should not have fractional CO2, and who should wait
Reasons to wait
Pregnancy.
Active acne, a skin infection or a cold sore in the area. Acne is brought under control first, because resurfacing inflamed skin adds new marks to old ones.
A fresh tan or recent intense sun, until the tan has fully faded.
Recent isotretinoin or photosensitising medicines, which are discussed, because advice on the interval varies.
Reasons for caution or a different plan
A tendency to keloid or hypertrophic scarring.
Poorly controlled diabetes, immunosuppression or smoking, which slow healing.
Previous radiotherapy to the area.
Active vitiligo.
Active melasma over the field, because melasma is provoked by heat and resurfacing is an ablative heat injury.
When fractional CO2 alone is a poor fit
Anyone who cannot accept a visible healing period may be better served by a gentler option. Scars that are mainly deep ice-pick tracts, or skin that is prone to keloids, tend to respond poorly to fractional CO2 on its own. Suspected keloid or hypertrophic scarring is referred for dermatology assessment, and extensive scar tissue that needs surgical revision for plastic surgery assessment.
What is checked before fractional CO2 is planned
Scar mapping. Each scar is graded by type and depth, under angled light and with the skin stretched to find tethers.
Medical history. Isotretinoin, photosensitising medicines, cold sores, keloid history, pregnancy or breastfeeding, diabetes, smoking and previous radiotherapy.
Skin type and pigment history. Your Fitzpatrick type and any darkening after earlier injury or laser.
A test area, where the reaction is uncertain. For example after darkening following an earlier laser elsewhere, a small area may be treated first and read after the delay in which pigment appears.
Preparation. Antiviral cover where there is a history of cold sores, retinoids and acids paused as advised, and daily sunscreen started before the first visit.
You leave with a written plan that states whether fractional CO2 is advised at all, where it sits in the sequence, the fee factors and the option of no treatment. The day itself is walked through on what to expect at a CO2 laser visit, healing phase by phase on CO2 laser downtime, and pigment planning on fractional CO2 in Asian skin.
If fractional CO2 is not suitable: the alternatives
Superficial scars or texture, or no wish for an ablative wound: the FSX Laser, non-ablative wavelengths that heat the dermis and leave the surface intact.
Pigment-prone skin, or shallow rolling scars: RF microneedling, which spares the surface; see RF microneedling for acne scars.
Tethered scars: subcision, which divides the band beneath the scar.
Ice-pick tracts: TCA CROSS placed into each tract.
Brown spots, melasma or redness: pico laser, R2T2 or medical treatment, after diagnosis.
A scar beyond non-surgical methods: referral for surgical revision.
How the methods are sequenced across one face is set out on acne scar treatment.
Your next step
1. MessageWhatsApp +65 8023 7170 with what is bothering you. A reply comes from the clinic, not a bot.
2. AssessmentDr Sin Yong examines you himself on Orchard Road, with ultrasound where earlier filler is involved.
3. A plan in writingWhat he would do, what he would not, the fee factors, and the option of no treatment.
Every treatment is performed by Dr Sin Yong personally. Singapore Medical Council registered · invited to share his clinical expertise internationally for CLASSYS, DEKA, Fotona, Hironic and Ilooda.
Book a scar assessment with Dr Sin Yong on Orchard Road; the scars are mapped before any laser is chosen. How consultations work.
Deep ice-pick scars may need TCA CROSS before resurfacing.
Frequently Asked Questions
Yes, with settings planned around pigment risk. In Fitzpatrick III to V skin, temporary darkening after fractional CO2 is the main concern, so density is kept conservative, depth is kept to where the scars need it, a fresh tan means waiting, and sun protection starts ahead of treatment and continues through healing. Where the skin's reaction is uncertain, a test area may be treated first.
Usually, with cover. Ablative laser on the face can trigger a cold sore flare, so anyone who has had cold sores should say so, and antiviral tablets are commonly prescribed to cover the healing period. An active cold sore in the area is a reason to wait until it has healed before fractional CO2 is done.
Not until the tan has fully faded. A fresh tan or recent intense sun means more active pigment cells and more reactive skin, which raises the risk of darkening after resurfacing. Daily broad-spectrum sunscreen starts before the first visit rather than after it, and the timing is confirmed when the skin is examined.
No. Fractional CO2 is not used for brown spots, melasma or redness. Melasma is provoked by heat, and resurfacing is an ablative heat injury, so active melasma over the field is a reason for caution. Pigment is diagnosed first and assessed for pico laser, R2T2 or medical treatment instead.
Anyone who is pregnant, has active acne, a skin infection or a cold sore, or a fresh tan should wait. A keloid tendency, poorly controlled diabetes, immunosuppression, smoking, previous radiotherapy to the area and active vitiligo call for caution. People who cannot accept a visible healing period, or whose scars are mainly deep ice-pick tracts, tend to be better served by another plan.
References
Treatment of Facial Acne Scarring With Fractional Carbon Dioxide Laser in Asians, a Retrospective Analysis of Efficacy and Complications. Dermatologic Surgery 43(9), 2017. source
Fractional resurfacing in the Asian patient: Current state of the art. Lasers in Surgery and Medicine 49(1), 2017. source
About this page: written and medically reviewed by Dr Sin Yong, MBBS (NUS), MRCS (Edinburgh) · Last reviewed 6 November 2026 · Illustrative images only, not patients · Editorial policy
