Guide · Fractional laser
Fractional laser in Singapore ablative vs non-ablative, downtime, and PIH in Asian skin
Fractional lasers treat the skin in a grid of microscopic columns so it heals faster. Here is how ablative CO2 differs from non-ablative thulium and erbium-glass lasers, what each day of downtime looks like, how many sessions to expect, and how to keep the risk of darkening low.
Quick answer
- A fractional laser treats the skin in a grid of microscopic columns and leaves untouched skin in between, so it heals faster than when the whole surface is treated. In Singapore, fractional laser is a doctor-performed treatment for acne scars, uneven texture, enlarged pores, fine lines and stretch marks.
- Ablative fractional lasers such as CO2 remove tiny columns of tissue and do more per session, with about five to seven days of swelling and fine crusts. Non-ablative lasers such as thulium and erbium-glass heat the skin beneath an intact surface, so redness usually settles within hours to a few days, but change builds more gradually over a course.
- The main risk in Asian skin is post-inflammatory hyperpigmentation (PIH). It rises with energy, density and bulk heating, and in one meta-analysis fractional CO2 carried about four times the PIH risk of RF microneedling; careful settings, cooling, no treatment while tanned and strict sun protection keep it down.
- At IN Eternity Clinic, Pacific Plaza, Dr Sin Yong performs S3 Resurfacing on the DEKA Tetra Pro fractional CO2 laser and the non-ablative FSX Laser, priced at consultation. SkinRev Lab does not use medical lasers; its SKINTIGHT microplasma treatment on the Alma PrimeX (S$588 per zone before GST) is a lighter-downtime option for surface texture.
The basics
What is a fractional laser?
Older laser resurfacing treated the whole skin surface at once, which meant weeks of healing. Fractional photothermolysis, described in 2004, splits the beam into thousands of microscopic treatment zones. In that first study each zone was about 0.1 mm wide and 0.3 mm deep, the surface healed within a day, and wrinkle scores around the eyes improved by 18% three months after treatment.
The untouched skin between the columns acts as a reservoir for repair, so healing is quicker than with full-surface resurfacing. Each controlled micro-injury prompts new collagen, which is why fractional lasers are used for acne scars, texture, enlarged pores, fine lines and stretch marks. Remodelling continues for months after each session.
Two settings shape both the result and the recovery: energy, which sets how deep each column goes, and density, which sets how much of the surface is treated. Both also change the risk of darkening in Asian skin.
Two families
Ablative vs non-ablative fractional laser
Fractional lasers fall into two families. The choice is mostly a trade between how much change you want per session and how much downtime and pigment risk you can accept.
The gap may be narrower than often assumed. A 2026 meta-analysis of four small randomised trials (98 people) comparing non-ablative erbium-glass with CO2 for acne scars found similar improvement, satisfaction and PIH rates, with less pain and shorter-lasting crusting and redness after erbium-glass. Because the trials were small, ablative lasers remain a main tool for deeper scars.
| Ablative fractional (CO2) | Non-ablative fractional (thulium, erbium-glass) | |
|---|---|---|
| What it does | Vaporises microscopic columns of skin, with a rim of heated tissue | Heats columns in the dermis; the surface stays intact |
| Wavelengths | 10,600 nm | Around 1,550 nm (erbium-glass) and 1,927 nm (thulium) |
| Mainly used for | Depressed acne and surgical scars, marked texture | Fine lines, pores, mild scarring, stretch marks, sun-related tone |
| Downtime | About 5 to 7 days of swelling and fine crusts; pinkness for weeks | Redness for hours to a few days; light scabs or flaking after stronger passes |
| Sessions | Fewer, spaced several weeks apart | A course, spaced weeks apart |
| PIH risk in Asian skin | Higher; needs careful settings and aftercare | Lower but present; falls with lower energy and density |
| In our network | S3 Resurfacing (DEKA Tetra Pro), IN Eternity Clinic | FSX Laser (thulium and erbium-glass), IN Eternity Clinic |
Ablative
Fractional CO2: S3 Resurfacing on the DEKA Tetra Pro
Fractional CO2 light at 10,600 nm is absorbed strongly by water in the skin, so each microbeam removes a narrow column of tissue and leaves a thin rim of heated tissue around it. That is why it can change the structure of a scar more than a non-ablative laser, and why recovery takes about a week.
At IN Eternity Clinic, Dr Sin Yong uses the DEKA Tetra Pro with his S3 protocol. Instead of one even pass, deeper single shots are placed into individual scar pits, then a fractional pass treats the surrounding skin so the scar blends in, with depth and density set separately. Numbing cream goes on for 45 to 60 minutes first, and it is often combined with subcision or TCA CROSS within his 4D Scar Reconstruction protocol.
It suits depressed acne scars, flat or depressed surgical and injury scars, and textured stretch marks, in people who can protect the area from sun for several weeks. It is not used over active acne, infection, cold sores or a fading tan, and raised or keloid scars need a different plan.
Non-ablative
Non-ablative options: FSX Laser and Luminescence Laser
Non-ablative fractional lasers use mid-infrared light, mainly erbium-glass at around 1,550 nm and thulium at 1,927 nm, absorbed by water in the skin. Erbium-glass reaches deeper into the dermis for scarring and fine lines; thulium works nearer the surface on sun-related tone and texture. The surface stays in place and acts as a natural dressing.
Dr Sin Yong's FSX Laser at IN Eternity Clinic is a non-ablative, multi-pass protocol combining thulium and erbium-glass energy, adjusted zone by zone, for fine lines, enlarged pores, rough texture and stretch marks. A session takes about 30 minutes after around 45 minutes of numbing cream; redness usually settles within hours, with light scabs for several days after stronger passes.
For scars, his Luminescence Laser is a separate non-ablative protocol calibrated for skin types III to VI, with mild redness for a few hours and sometimes dryness or slight swelling for one to three days. Research on erbium-glass and thulium systems supports this class of laser, but FSX and Luminescence are clinic protocols, so the studies support the mechanism rather than the protocols themselves.
Downtime
Fractional laser downtime, compared
These are typical patterns, not promises; the settings, the area and your skin all change recovery. Plan fractional CO2 before a quiet week, keep out of direct sun, and use only the aftercare you are given until the skin has closed.
| Treatment | Day 0 to 1 | Days 2 to 7 | After the first week |
|---|---|---|---|
| Non-ablative (FSX type) | Redness and warmth for a few hours | Usually back to normal; light scabs or flaking after stronger passes | Collagen builds over the following one to two months |
| Luminescence (non-ablative, scars) | Mild redness for a few hours | Sometimes dryness or slight swelling for one to three days | Gradual scar remodelling over months |
| Fractional CO2 (S3 Resurfacing) | Hot, tight, sunburn-like feeling; swelling begins | Swelling peaks in the first three days; fine brown crusts flake by about day 5 to 7 | Pinkness fades over two to four weeks; make-up once the skin has closed |
| SKINTIGHT microplasma, tightening setting | Mild redness for a few hours | Usually nothing visible | Firmness and texture change over the following weeks |
| SKINTIGHT microplasma, scar setting | Redness | Pinpoint scabbing for a few days | Texture changes over the following weeks |
Sessions and results
How many sessions, and what the evidence shows
Non-ablative treatments are usually given as a course spaced several weeks apart, because each session does less and collagen needs time to remodel. Fractional CO2 often needs fewer sessions, also spaced weeks apart. Change builds over one to several months after each session, so judge progress with photographs taken in the same light rather than in the mirror the next week.
For acne scars, a 2026 meta-analysis of eight randomised trials (249 patients) found fractional CO2 gave more scar improvement and higher satisfaction than RF microneedling, but with more pain, about 1.7 more days of redness and a PIH risk about four times higher. A 2022 international consensus of 24 dermatologists and plastic surgeons lists ablative and non-ablative fractional lasers among the devices they most often choose for acne scars, often combined with other methods.
No laser turns a scar back into untouched skin. Most people see scars soften and blend rather than disappear, and individual results vary.
Asian skin
Keeping PIH risk down in Asian skin
Melanin competes with the laser's target, and heat stimulates pigment cells, so post-inflammatory hyperpigmentation (PIH) is the main risk of fractional laser in Asian skin. It usually fades over months, but it can mask the improvement in the meantime.
In a study of 37 Chinese patients treated with a 1,540 nm fractional laser, generalised PIH followed 7.1% of high-energy, low-density sessions and 12.4% of low-energy, high-density sessions. The difference was not statistically significant, but the authors concluded density may matter more, and localised darkening around the mouth occurred in people treated without air cooling. A 2026 review of 15 studies of erbium-glass and thulium lasers in skin of colour also found less PIH at lower energy and density.
- Do not have fractional laser while tanned or sunburnt; treatment is usually postponed.
- Pause exfoliating acids, scrubs and retinoids for about a week beforehand, or as advised.
- Tell the doctor about past dark marks after spots, bites or treatments, and about cold sores.
- Expect conservative settings at first, with cooling during treatment.
- Use only the recommended aftercare at first, do not pick crusts, and use sunscreen daily once the skin has closed.
- Report new darkening early, so the plan can be adjusted.
A lighter option
SKINTIGHT microplasma at SkinRev Lab: lighter downtime
SKINTIGHT at SkinRev Lab is not a laser. It uses the microplasma mode of the Alma PrimeX: radiofrequency energy at 40.68 MHz is released through fine pins that discharge close to the skin, forming plasma that creates micro-channels in the surface while conducting heat into the upper dermis. Like a fractional laser, it treats a pattern of tiny zones and leaves untouched skin between them.
A session takes about 30 minutes, with numbing cream available. On tightening, texture and glow settings, most people have mild redness for a few hours; scar settings are deliberately stronger and leave pinpoint scabbing for a few days. SKINTIGHT is S$588 per zone before GST, for the face, the neck and double chin, the upper and lower eyes, or a 15 × 15 cm body area, usually as a short course planned at your assessment.
Its action is shallower than a dermal laser, so it suits surface texture, pores, mild laxity and early scarring better than deep acne scars, which still need a doctor-performed laser or a combined scar plan. Evidence for microplasma is more limited: in a 2010 pilot study of 16 people, a fractional microplasma radiofrequency device improved acne scars and wrinkles over two to four sessions with short downtime. Our team is trained on the Alma PrimeX by Dr Sin Yong.
Who should wait
Who should wait, or choose another option
- Active acne, infection, cold sores or open wounds in the area.
- A recent tan or sunburn, or a beach holiday planned soon after treatment.
- Pregnancy.
- A tendency to keloids or thick raised scars, especially before ablative treatment.
- Recent isotretinoin; timing is discussed individually with the doctor.
- Medicines or conditions that make you sensitive to light or slow healing.
- Melasma: heat-based treatments can flare it, so a doctor plans the pigment first.
- Skin that darkens easily after any injury: a non-ablative laser or RF microneedling may be a safer start than CO2.
In Singapore
Fractional laser in Singapore: who performs it
In Singapore, high-power lasers are licensed by the National Environment Agency, and class 4 lasers may be used on people only by registered doctors at premises approved by the Ministry of Health. A fractional laser is therefore a doctor's procedure, and it starts with a diagnosis, because scars, pores, pigment and redness can look alike and need different plans.
At IN Eternity Clinic, 9 Scotts Road, #12-01 Pacific Plaza, beside Orchard MRT, Dr Sin Yong performs S3 Resurfacing, FSX Laser and Luminescence Laser, three of his signature protocols, and decides which suits your skin after examining it. Each is priced at consultation by the clinic; WhatsApp +65 8815 3008. SkinRev Lab, at CityLink Mall #B1-28 by City Hall MRT, does not use medical lasers and passes laser enquiries to the clinic.
- Is the laser ablative or non-ablative, and why that one for my skin?
- How many sessions, how far apart, and how much downtime each time?
- How will you set it for my skin type to limit PIH?
- Who performs the treatment, and who reviews me afterwards?
Sources
References & sources
- Manstein D, Herron GS, Sink RK, Tanner H, Anderson RR. Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med. 2004;34(5):426-438.
- Chan HH, Manstein D, Yu CS, Shek S, Kono T, Wei WI. The prevalence and risk factors of post-inflammatory hyperpigmentation after fractional resurfacing in Asians. Lasers Surg Med. 2007;39(5):381-385.
- Salameh F, Shumaker PR, Goodman GJ, et al. Energy-based devices for the treatment of acne scars: 2022 international consensus recommendations. Lasers Surg Med. 2022;54(1):10-26.
- Xue D, Yu Y, Li X, et al. Efficacy and safety of Er:Glass versus CO2 lasers in the treatment of atrophic acne scars: a systematic review and meta-analysis. Aesthetic Plast Surg. 2026;50(7):2731-2740.
- Argobi Y, Tobeigei F, Alasiri FI. Fractional CO2 laser versus micro needling radiofrequency for post acne scarring: a meta-analysis of RCTs. J Cosmet Dermatol. 2026;25(3):e70765.
- Goldman MP, Wu DC, Khetarpal S, Jacobson A, Wang JV, Geronemus RG. Dual 1550-nm erbium glass fiber and 1927-nm thulium fiber non-ablative fractional laser system treatment in patients with skin of color: a review of clinical studies and unmet needs. Lasers Surg Med. 2026;58(3):169-179.
- Halachmi S, Orenstein A, Meneghel T, Lapidoth M. A novel fractional micro-plasma radio-frequency technology for the treatment of facial scars and rhytids: a pilot study. J Cosmet Laser Ther. 2010;12(5):208-212.
Common questions
Your questions,
answered
What is fractional laser used for?
Mainly acne scars, uneven texture, enlarged pores, fine lines, stretch marks and some surgical scars. It works by prompting new collagen in a grid of tiny treated zones. It is not the first choice for melasma, active acne or visible thread veins.
How long is the downtime after fractional laser?
It depends on the type. Non-ablative fractional laser usually means redness for hours to a few days. Fractional CO2 means about five to seven days of swelling and fine crusts, with pinkness fading over two to four weeks.
Fractional CO2 or non-ablative laser for acne scars?
Deeper scars usually get more change per session from CO2, at the cost of about a week's downtime and a higher PIH risk. Non-ablative lasers suit milder scarring and people who cannot take time off. Small trials suggest the gap may be narrower than assumed, and many plans combine lasers with subcision or TCA CROSS.
How many fractional laser sessions will I need?
It varies with the concern and the laser. Non-ablative treatments are usually a course of several sessions spaced weeks apart; CO2 often needs fewer. A doctor sets the plan after examining your skin, and results build over months.
Is fractional laser safe for Asian skin?
It can be used, but PIH is the main risk. Lower energy and density, cooling, avoiding treatment while tanned and strict sun protection reduce it. Fractional CO2 carries a higher risk than non-ablative lasers or RF microneedling.
Does fractional laser hurt?
Numbing cream is applied for about 45 to 60 minutes first. Non-ablative passes feel like warm, prickling pulses; CO2 feels hotter and is followed by a sunburn-like sensation for a day or two.
Fractional laser vs RF microneedling: what is the difference?
Fractional laser uses light, ablative or not; RF microneedling uses fine needles to deliver radiofrequency heat into the dermis. In a meta-analysis of acne scar trials, CO2 improved scars more, while RF microneedling had less pain, shorter redness and lower PIH risk.
Is SKINTIGHT a fractional laser?
No. SKINTIGHT at SkinRev Lab uses Alma PrimeX microplasma, a radiofrequency-based technology, to make a fractional pattern of tiny surface channels. Downtime is lighter than with an ablative laser, but it works more superficially. It is S$588 per zone before GST.
How much does fractional laser cost in Singapore?
It depends on the laser, the area and the number of sessions. At IN Eternity Clinic, S3 Resurfacing and FSX Laser are priced at consultation by the clinic after Dr Sin Yong has assessed your skin. Compare the whole course, including downtime, rather than one session.