Fractional CO2 Laser



What is Fractional CO2 Laser?

Fractional CO2 Laser, or fractionated carbon dioxide laser, is an ablative laser commonly used to treat depressed atrophic acne scars and uneven skin textures. It is also effective in rejuvenating aged skin, reducing the appearance of enlarged pores, fine lines and wrinkles.

Fractional CO2 Laser is a non-invasive, non-surgical procedure performed in an outpatient setting. It is based on the original Carbon Dioxide (CO2) Laser.

Remove unsightly lumps, bumps, moles with our Spot-Guided CO2 Laser

How does Fractional CO2 Laser help treat Acne Scars?

Acne is a fact of life; almost 80% of people between the ages of 11 and 30 will have had acne at some point in their lives.

And with acne comes the risk of leaving acne scars behind. These acne scars can persist on a person’s skin (not to mention face) and affect the self-confidence of many patients. One common type of acne scar is the atrophic or depressed acne scar.

Depressed Acne Scars

Depressed or Atrophic acne scars are further subcategorised into Ice Pick, Rolling, and Boxcar scars. (

The main characteristic of a depressed acne scar is the loss of tissue as the skin heals after an acne breakout. This loss of tissue causes the depression and unevenness of atrophic acne scars.

Want to know what type of acne scars you may have? Read more here.

Resurfacing procedures such as the Fractional CO2 Laser aims to reduce acne scarring by levelling out the depression.

Fractional co2 laser skin resurfacing

Fractional CO2 Laser Skin Resurfacing Process (

In the case of the Fractional CO2 Laser, it delivers laser energy in a “fractionated” or “pixellated” manner – a grid of light is beamed into the deep layers of skin while at the same time leaving pockets of skin untouched.

You can expect a downtime of up to a week, sometimes more, depending on individual healing.

The light energy from the Fractional CO2 Laser creates tiny openings on your skin, reaching into the dermis level to break up fibrous tissue. In response, your skin then repairs these openings by pushing out damaged and uneven skin with healthier, even skin tone.

This pushing out of damaged skin is the resurfacing act in itself; this means you will experience skin flaking during the recovery process. Out with the old, in with the new.

This reparation process is helped even further by the laser. The residual heat from the laser stimulates your skin to produce new collagen, a building block of skin. This is called collagen remodelling. The result? Visibly even complexion.

The Benefits of Fractional CO2 Laser

The Fractional CO2 Laser has been in the market for over 20 years and used extensively by aesthetic practitioners around the world. When performed by our qualified doctor, you can expect to see:

  • Improvements in skin texture
  • Reduction in depressed, atrophic acne scars or surgical scars
  • Minimalised and reduced pore size
  • Can be paired with other acne scar treatments such as Subcision, and TCA CROSS to treat varying types of acne scarring

What Fractional CO2 Laser Can’t Do

Fractional CO2 Laser does not treat skin redness such as dilated blood vessels or spider veins (telangectasias) and red discolourations on the chest or neck (poikiloderma). In fact, it can even worsen these problems.

But more importantly, acne scar removal cannot be achieved by Fractional CO2 Laser, or any other treatment available in the market. Why? SL Aesthetic Clinic’s Medical Director Dr Kelvin Chua shares his view here.

When Will I See Results with Fractional CO2 Laser?

Most patients see improvements after just 1 session. Of course, this is only an improvement. Just like how the body needs time to repair itself, skin resurfacing and collagen remodelling will likewise take time.

How soon you’ll see the full results with Fractional CO2 Laser will depend on many factors. Chief amongst them is the severity of the acne scar and your tolerance for downtime.

We recommend 3 sessions for mild acne scarring and up to 6 or more sessions for severe acne scarring. Each session should ideally be done on a monthly basis; but herein lies the issue. Bearing in mind the downtime of up to a week, not everyone can afford to have it done once a month.

With Fractional CO2 Laser, it is always a balancing act between resolving your acne scars and keeping downtime to a minimum. The power of the Fractional CO2 can be customised for a lower downtime. But this also means a higher frequency of treatment is required.

Hence, it’s important that you share as much information about your daily habits, medical history, and highlight your tolerance for downtime. This will help our doctor work out a treatment plan for you.

The frequency of treatments aside, whether the Fractional CO2 Laser is combined with other treatments will also influence the results.

How Many Treatments of Fractional CO2 Laser Will I Need?

The number of sessions you need will depend on the extent of the acne scarring, your tolerance for downtime, and the expected results.

Here are some useful guides in determining the number of sessions you’ll require:

  • The more severe the acne scarring, the more sessions you’ll require
  • The less tolerant you are to downtime, the more sessions you’ll require
  • If you’re looking to achieve drastic results at the end of the treatment, the more sessions you’ll require

What’s more, your tolerance to downtime is directly affected by your work schedule, daily obligations, as well as how dark your complexion is.

Melanin pigments absorb light energy. Hence, darker skinned patients who naturally have high levels of melanin in their skin will have a likewise, increased risk of laser burns. To minimise this, we perform Fractional CO2 Laser treatments at a lower power level for this group of patients, but with increased frequency to achieve the desired results.


Fractional laser differs from other lasers in its mode of delivery. While conventional lasers use a laser as a moving beam so that the surface of the skin is ablated through, Fractional CO2 laser uses a grid-like technology where lathe ser is delivered as a multi-pointed laser. This leaves a significant amount of the outer skin largely intact.

This means a patient can experience less sensitivity from external environmental factors such as the sun. And the patient’s skin healing is optimised. Because of continuous advancements in fractional technology, the adverse effects of other conventional CO2 lasers can be avoided, yet retaining beneficial results and minimised downtime. As with any procedure or treatment, results and downtime can vary by the individual.

Fractional CO2 Laser is our preferred treatment for acne and surgical scars. It is also beneficial for open pores and reducing fine lines. As with any procedure or treatment, results can vary by individual.

The treatment can take about 60 minutes or more, depending on the area(s) treated. A numbing cream is applied prior to the treatment. Fractional laser is then applied part by part. Thereafter, an optional post-laser mask is applied to speed up the recovery process.

We recommend 3-6 courses of treatment, to be done 4-6 weeks apart. For severe scars, 6 or more courses are recommended.

Downtime can last about 4-5 days or more. The initial recovery can see some redness in the skin, which can gradually fade away. We recommend to avoid the use of any cosmetic products for the first 2 days of recovery, to wash with tepid water, and avoid direct and prolonged exposure to sun light for approximately 2 weeks or more.

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