Guide · Laser resurfacing
Laser resurfacing in Singapore CO2, erbium and non-ablative lasers, and what each asks of your recovery
Laser resurfacing can mean a week of crusting or an afternoon of redness, depending on the laser. Here is how ablative CO2 and erbium:YAG differ from non-ablative erbium-glass and thulium, why ‘erbium laser’ can mean two different machines, what recovery and results to expect, and how to keep Asian skin from darkening.
Quick answer
- Laser resurfacing uses laser light absorbed by water in the skin to remove or heat thin layers or tiny columns of tissue, so the skin rebuilds with new collagen and a smoother surface. In Singapore it is a doctor-performed treatment for acne scars, rough texture, fine lines and sun damage.
- Ablative lasers, CO2 at 10,600 nm and erbium:YAG at 2,940 nm, remove tissue and do the most per session; fractional CO2 means about a week of swelling and fine crusts. Non-ablative lasers such as erbium-glass and thulium heat beneath an intact surface, so redness usually lasts hours to days, but change builds more slowly over a course.
- Erbium:YAG leaves less heat behind than CO2: in a split-face study it healed faster and caused pale skin far less often, while CO2 smoothed wrinkles more. In Asian skin the main risk of any resurfacing is post-inflammatory hyperpigmentation (PIH); after fractional CO2, mild PIH appeared in 92% of 13 Asian patients and cleared in about five weeks.
- In our network, Dr Sin Yong performs S3 Resurfacing, using the DEKA Tetra Pro fractional CO2 laser, and the non-ablative FSX Laser at IN Eternity Clinic; both are priced at consultation. SkinRev Lab has no laser resurfacing, and its own option, SKINTIGHT microplasma on the Alma PrimeX, is S$588 per zone before GST.
The basics
What laser resurfacing means today
Laser resurfacing began with ablative lasers that removed the whole skin surface. They worked, but healing took about two weeks and complications, including scarring with the earliest continuous-wave CO2 lasers, were a real concern. That led first to non-ablative lasers, which heat the dermis while keeping the surface intact, and then to fractional lasers, which treat only a grid of microscopic columns and leave bridges of untouched skin between them.
A review in the Journal of the American Academy of Dermatology set out the trade-off that still holds: fractional resurfacing sits between the two, more effective than non-ablative treatment and quicker to recover from than full ablation, while neither non-ablative nor fractional treatment matches full ablative resurfacing for results. Both became more popular because they limit risk while giving acceptable improvement.
Every resurfacing laser targets water, which makes up most of the skin. What differs is how strongly that water absorbs the wavelength, how much heat is left behind in the tissue, and whether the surface is removed or left in place. Those three things set the result, the downtime and the pigment risk.
The types
Laser resurfacing types: ablative, fractional and non-ablative
Fractional and non-ablative lasers have become far more popular than full-surface ablation, largely because treating columns rather than the whole surface shortens healing and limits risk, which matters for skin that darkens easily.
| Ablative, full surface | Ablative fractional | Non-ablative fractional | |
|---|---|---|---|
| Lasers | CO2 (10,600 nm) or erbium:YAG (2,940 nm) | CO2 or erbium:YAG, delivered as a grid of columns | Erbium-glass (about 1,540 to 1,550 nm) and thulium (1,927 nm) |
| The skin surface | Removed across the whole area | Removed in microscopic columns only | Left intact; heat works beneath it |
| Visible healing | About two weeks; redness can last weeks | Roughly a week of swelling and fine crusting with CO2 | Redness for hours; light scabs for a few days after stronger passes |
| Change per session | Largest | Large | Smaller; builds over a course |
| Usual sessions | Often one | One to a few, several weeks apart | A course, weeks apart |
| PIH risk in Asian skin | Highest; CO2 can also leave pale skin | High but usually temporary | Lower; falls with lower energy and density |
| In our network | Not listed | S3 Resurfacing (fractional CO2), IN Eternity Clinic | FSX Laser, IN Eternity Clinic |
CO2 vs erbium
CO2 or erbium:YAG: how the two ablative lasers differ
Both remove tissue, but they leave different amounts of heat behind. Erbium:YAG light at 2,940 nm is absorbed by water even more strongly than CO2 light at 10,600 nm, so each pass vaporises a thinner layer and leaves less heated tissue around it. CO2 leaves a wider rim of heated tissue, which adds a tightening effect but lengthens recovery.
A split-face study published in 1999 showed the trade-off in 21 volunteers with skin types I to III. The CO2 side gave better overall wrinkle improvement, although more than five erbium:YAG passes performed about as well as two or three CO2 passes. At two weeks, redness affected 95% of CO2 sides and 67% of erbium:YAG sides, and pale skin (hypopigmentation) appeared on 43% of CO2 sides against 5% of erbium:YAG sides. Residual heat damage reached about 200 µm with CO2 and 50 µm with erbium:YAG.
In fractional form, the gap narrows. In a randomised split-face trial of 24 Asian patients with acne scars, two sessions of fractional erbium:YAG on one side and fractional CO2 on the other gave similar results at six months: 55% and 65% of sides respectively improved by more than half, a difference that was not significant. The CO2 side was more uncomfortable.
Erbium laser
‘Erbium laser’ can mean two different lasers
When a clinic says erbium laser, ask which one. Erbium:YAG at 2,940 nm is an ablative laser that removes tissue. Erbium-glass, at about 1,540 to 1,550 nm, is a non-ablative laser that heats columns of dermis beneath an intact surface. They share a word and little else that matters to your recovery: one can mean several days of crusting, the other usually means redness for hours, with light scabs for a few days after stronger passes.
Erbium-glass is often paired with thulium at 1,927 nm, which is absorbed nearer the surface and is used for sun-related tone and texture. A 2026 review of 15 studies of a combined 1,550 and 1,927 nm system in skin types III to VI reported consistent improvement in scarring with the erbium-glass wavelength and in photoageing with thulium, and lower PIH rates when energy or density was reduced.
At IN Eternity Clinic, this erbium-glass and thulium pairing is used in Dr Sin Yong's FSX Laser, a non-ablative protocol of several passes with the energy adjusted area by area, aimed at fine lines, enlarged pores, rough texture and stretch marks. Because FSX is a clinic protocol, studies of these wavelengths support the type of laser rather than the protocol itself.
Downtime and results
Downtime and results, side by side
Recovery follows the depth of injury, not the brand of machine. These are typical patterns, not promises; energy, density, the area treated and your own skin all change what you see.
If you are having fractional CO2, book it before a quiet week, stay out of direct sun, and stick to the aftercare products you were given until the surface has healed. After non-ablative passes, most people are back at work the same day or the next.
| Treatment | What you will notice | Social downtime | When change shows |
|---|---|---|---|
| Fractional CO2 (S3 Resurfacing) | Heat like a strong sunburn, swelling that peaks in the first three days, then fine brown crusts | About a week; pinkness fades over two to four weeks | Builds over months as collagen remodels |
| Non-ablative (FSX Laser) | Warmth and redness; light scabs after stronger passes | Usually hours; a few days after stronger passes | Over one to two months after each session, across a course |
| SKINTIGHT microplasma, tightening setting | Mild redness | A few hours | Over the following weeks |
| SKINTIGHT microplasma, scar setting | Pinpoint scabbing | A few days | Across a course |
Who suits which
Matching the laser to the skin
The right depth depends on what you are treating and how much recovery you can take. The first step is a doctor's examination, since a scar, an enlarged pore, a pigment mark and a patch of redness can look similar yet need quite different treatment.
- Deep acne scars, surgical scars and marked texture: ablative fractional CO2, often combined with subcision or TCA CROSS, if you can take a week out and protect the skin from sun.
- Fine lines, enlarged pores, mild scarring and stretch marks, with little time off: a non-ablative course such as FSX.
- Early crepey skin and surface texture, without a medical procedure: microplasma such as SKINTIGHT at SkinRev Lab, accepting a shallower effect.
- Skin that darkens easily after any injury: start gentler, with non-ablative settings or RF microneedling, before considering CO2.
- Melasma: heat can flare it, so the pigment is planned first.
- Active acne, cold sores, infection, a recent tan, pregnancy, a tendency to keloids or recent isotretinoin: wait, and agree the timing with the doctor.
Asian skin
Precautions for Asian skin
Melanin competes with the laser for energy, and heat stimulates pigment cells, so post-inflammatory hyperpigmentation is the most common side effect of resurfacing in Asian skin. In a study of 13 patients with skin type IV treated with three sessions of fractional CO2 for acne scars, 85% had at least 25 to 50% improvement at six months, while mild PIH appeared in 92% of patients, after about half of all sessions, and cleared in an average of five weeks.
How the laser is set matters too. A study of 37 Chinese patients treated with a 1,540 nm non-ablative fractional laser recorded generalised darkening after 7.1% of sessions that used high energy at low density, against 12.4% of sessions that used low energy at high density; the gap was not statistically significant. People treated without air cooling developed local darkening around the mouth, and the authors concluded that density, energy and cooling all play a part.
- No resurfacing while tanned or sunburnt; plan sessions away from beach holidays.
- Stop scrubs, exfoliating acids and retinoids about a week ahead, unless your doctor advises otherwise.
- Tell the doctor about past darkening after spots, bites or treatments, and about cold sores or keloids.
- Expect conservative energy and density at first, with cooling during treatment.
- Once the skin has healed over, wear sunscreen every day; UV in Singapore stays high year-round.
- Report new darkening early; it usually fades, and the plan can be adjusted.
In our network
S3 Resurfacing and FSX Laser at IN Eternity Clinic
Both belong to Dr Sin Yong's ten signature protocols, and he performs them himself at IN Eternity Clinic, 9 Scotts Road, #12-01 Pacific Plaza, beside Orchard MRT. S3 Resurfacing runs on the DEKA Tetra Pro, a 10,600 nm fractional CO2 laser, and is planned scar by scar: deeper single shots are placed into individual scar pits before a fractional pass over the surrounding skin blends the edges, with depth and density set independently. The skin is numbed with cream for 45 to 60 minutes beforehand, and the laser is often paired with subcision or TCA CROSS.
FSX Laser is the gentler, non-ablative choice: about 30 minutes of erbium-glass and thulium passes after roughly 45 minutes under numbing cream, with redness that usually fades within hours. Each is planned as a course with sessions weeks apart and priced at consultation by the clinic, which is open Monday to Saturday, 11am to 8pm; WhatsApp +65 8815 3008.
If you are specifically interested in erbium:YAG resurfacing, the doctor can advise whether it would suit your skin and your concern.
Without a laser
SKINTIGHT microplasma at SkinRev Lab
SkinRev Lab does not offer laser resurfacing. Its resurfacing option is SKINTIGHT, which uses the microplasma mode of the Alma PrimeX: radiofrequency energy at 40.68 MHz discharges through fine pins held close to the skin, forming plasma that opens microscopic channels in the surface and conducts heat into the upper dermis. No needles pierce the skin, and untreated skin is left between the channels.
Sessions last about 30 minutes, and numbing cream can be applied first. On tightening, texture and glow settings, expect mild redness that fades within a few hours; scar settings are deliberately stronger and leave pinpoint scabs for a few days. SKINTIGHT is S$588 per zone per session before GST, where a zone is the face, the neck and double chin, the upper and lower eyes together, or a 15 × 15 cm body area. A short course is planned at your assessment, and the team is trained hands-on on the Alma PrimeX by Dr Sin Yong, SkinRev Lab's medical adviser.
It works more superficially than a dermal laser, so it suits surface texture, pores, crepey skin and early scarring better than deep or pitted acne scars. The evidence is thinner too: in a 2010 pilot study, 16 people treated every four weeks with a fractional microplasma radiofrequency device showed improvement in acne scars and wrinkles after two to four sessions, with short-lived redness.
Before you book
Questions to ask before laser resurfacing in Singapore
Resurfacing lasers are high-power class 4 devices. In Singapore, the National Environment Agency licenses class 4 lasers and permits their use on people only by registered doctors in premises approved by the Ministry of Health, so resurfacing here is a doctor's procedure that should begin with a diagnosis.
Clear answers to these questions, including what the laser will not do, are a better guide than a package price.
- Is this laser ablative or non-ablative, and is it CO2, erbium:YAG, erbium-glass or thulium?
- Why this laser for my skin type and my concern?
- How many sessions, how far apart, and what will recovery look like each time?
- How will the settings limit PIH, and what happens if my skin darkens?
- Who will do the treatment, and who will check on me afterwards?
- Is the price per session or per course, and does it include GST?
Sources
References & sources
- Alexiades-Armenakas MR, Dover JS, Arndt KA. The spectrum of laser skin resurfacing: nonablative, fractional, and ablative laser resurfacing. J Am Acad Dermatol. 2008;58(5):719-737.
- Khatri KA, Ross V, Grevelink JM, Magro CM, Anderson RR. Comparison of erbium:YAG and carbon dioxide lasers in resurfacing of facial rhytides. Arch Dermatol. 1999;135(4):391-397.
- Manuskiatti W, Iamphonrat T, Wanitphakdeedecha R, Eimpunth S. Comparison of fractional erbium-doped yttrium aluminum garnet and carbon dioxide lasers in resurfacing of atrophic acne scars in Asians. Dermatol Surg. 2013;39(1 Pt 1):111-120.
- Manuskiatti W, Triwongwaranat D, Varothai S, Eimpunth S, Wanitphakdeedecha R. Efficacy and safety of a carbon-dioxide ablative fractional resurfacing device for treatment of atrophic acne scars in Asians. J Am Acad Dermatol. 2010;63(2):274-283.
- 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.
- 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 laser resurfacing?
A laser treatment that removes or heats thin layers or microscopic columns of skin so it heals with new collagen and a smoother surface. Ablative lasers (CO2, erbium:YAG) remove tissue; non-ablative lasers (erbium-glass, thulium) heat beneath an intact surface. In Singapore, it is a doctor's procedure.
Is erbium laser better than CO2 laser?
Neither is better in every case. Erbium:YAG leaves less heat behind, so it usually heals faster and causes pale skin less often; CO2 adds more tightening and, in older studies, more wrinkle improvement per treatment. In a trial in Asian patients with acne scars, fractional versions of the two gave similar results, with CO2 more uncomfortable.
How long is the downtime after laser resurfacing?
It depends on the laser. Non-ablative resurfacing usually means redness for hours, sometimes light scabs for a few days. With fractional CO2, expect about a week of swelling and fine crusting, then pinkness that fades over two to four weeks. Full-surface ablative resurfacing takes about two weeks to heal.
Is laser resurfacing safe for Asian skin?
It can be done, but post-inflammatory hyperpigmentation is common, especially after ablative lasers; in one study of Asian patients treated with fractional CO2, mild PIH appeared in most and cleared in about five weeks. Gentle settings, cooling, waiting until any tan has faded and careful sun protection all lower the risk.
How many laser resurfacing sessions will I need?
Fractional CO2 is often done once or a few times, several weeks apart. Non-ablative lasers are given as a course spaced weeks apart, because each session does less. Your doctor plans the number after examining your skin, and results build over months.
Does laser resurfacing work for acne scars?
It can soften depressed acne scars; in one trial in Asian patients, more than half of the treated sides improved by over 50% after two sessions. It rarely removes scars completely, and deep or tethered scars usually do better when laser is combined with subcision or TCA CROSS.
What is the difference between laser resurfacing and fractional laser?
Fractional laser is a way of delivering resurfacing. Instead of treating the whole surface, the laser treats a grid of tiny columns and leaves untouched skin between them, which shortens healing. Fractional delivery is now common for both ablative and non-ablative lasers.
Does SkinRev Lab offer laser resurfacing?
No. SkinRev Lab, a non-invasive aesthetic centre, has no medical lasers. Its SKINTIGHT treatment uses Alma PrimeX microplasma, a radiofrequency-based technology, for surface texture and tightening at S$588 per zone before GST. For laser resurfacing, SkinRev Lab passes your enquiry to Dr Sin Yong at IN Eternity Clinic.
How much does laser resurfacing cost in Singapore?
The cost turns on which laser is used, how large the area is and how many sessions you need. IN Eternity Clinic quotes S3 Resurfacing and FSX Laser at consultation, once Dr Sin Yong has examined your skin. When comparing, look at the full course and the time off it needs, not just one session.