Pico Laser for Acne Scars: Does It Really Work in Malaysia

Acne scars can affect more than skin texture. For many people, they also affect confidence, makeup application, and the way light reflects on the face. In Malaysia, where many people have medium to deeper skin tones, acne scar treatment needs to be chosen carefully to reduce the risk of irritation, post-inflammatory hyperpigmentation, and unnecessary downtime.

Pico Laser has become a popular option for acne scars because it is designed to improve skin texture without removing the top layer of the skin in the same way as traditional ablative lasers. At AVA Clinic, patients can explore doctor-led aesthetic treatments that are tailored according to skin condition, scar type, and individual concerns.

What Causes Acne Scars?

Acne is a chronic inflammatory condition involving the pilosebaceous unit, which includes the hair follicle and oil gland. When acne becomes inflamed, especially in deeper or more severe breakouts, the surrounding skin tissue may become damaged. If the inflammation is prolonged, untreated, or repeatedly triggered, the skin may heal unevenly and leave scars behind.

Scarring is part of the body’s natural wound-healing process. When the skin repairs damaged tissue, fibrous tissue may replace normal skin structure. This can lead to different scar patterns. Atrophic scars are sunken or depressed scars and are the most common type of acne scars. Hypertrophic scars are raised scars caused by excess collagen. Keloid scars are raised scars that extend beyond the original acne lesion.

According to the American Academy of Dermatology, acne scar treatments may include procedures such as laser treatments, fillers, microneedling, chemical peels, and other methods depending on the scar type and severity. Different scar types often need different treatment approaches, which is why proper consultation is important.  

What Types of Acne Scars Can Develop?

Acne scars are not all the same. Understanding the type of scar helps determine whether Pico Laser is suitable on its own or whether combination treatment may be needed.

Boxcar scars are round or oval depressions with more defined edges. They may be shallow or deep, depending on how much tissue has been lost. Rolling scars are wider depressions with sloping edges that create a wavy, uneven appearance across the skin. Ice pick scars are narrow but deep scars that extend into the dermis, often appearing like small punctures.

Hypertrophic and keloid scars are raised scars caused by excess collagen during healing.

In general, fractional laser-based treatments are often more suitable for shallow to moderate atrophic scars, rough skin texture, enlarged pores, and uneven skin tone. Deeper ice pick scars may require combination treatments such as subcision, TCA CROSS, microneedling, radiofrequency, or other procedures depending on the doctor’s assessment.

Does Pico Laser Work for Acne Scars?

Pico Laser can help improve the appearance of acne scars, especially when the scars are mild to moderate and linked to uneven texture, shallow depressions, enlarged pores, or post-acne marks. It does not “erase” scars instantly, but it can support gradual skin remodelling by stimulating collagen production and encouraging healthier skin renewal.

Unlike ablative lasers, such as some CO2 laser treatments, Pico Laser does not work by vaporising the skin surface. Instead, it delivers ultra-short pulses of energy into the skin. This creates a photomechanical effect that helps stimulate skin repair with less surface injury. AVA Clinic describes its picolaser treatment as using short picosecond pulses that create photoacoustic effects and micro-cavitation within the skin, supporting collagen and elastin stimulation.  

This makes the treatment appealing for people who want improvement but prefer shorter downtime. However, results depend on scar type, scar depth, skin response, acne control, treatment settings, and the number of sessions completed.

How Fractional Pico Laser Improves Acne Scars

Fractional Pico Laser works by delivering laser energy in tiny focused spots. These controlled treatment zones affect the epidermis and dermis without causing broad damage to the surrounding tissue. The laser energy may create laser-induced optical breakdown and laser-induced cavitation, which form tiny microscopic changes beneath the skin.

In simple terms, the laser creates very small invisible treatment zones below the surface. These zones activate the skin’s repair response. As the skin heals, it may produce new collagen, increase elastin support, improve firmness, and remodel uneven scar tissue over time.

This is important for acne scars because many depressed scars are caused by a loss or distortion of collagen in the dermis. When collagen remodelling improves, the skin may appear smoother, firmer, and more even. The improvement is usually gradual rather than immediate because collagen formation takes time.

Pico Laser may also improve other concerns that often appear together with acne scars, including enlarged pores, dullness, uneven tone, rough texture, and post-inflammatory pigmentation. AVA Clinic’s picolaser page lists acne scars, enlarged pores, pigmentation, acne, wrinkles, and rejuvenation among its treatment benefits.

Why Is Pico Laser Popular in Malaysia?

Malaysia’s climate and common skin profiles make acne scar treatment more complex. Heat, humidity, sweating, oily skin, and frequent sun exposure can contribute to acne flare-ups and pigmentation concerns. Many Malaysian patients also have skin tones that are more prone to post-inflammatory hyperpigmentation after aggressive treatment.

For this reason, non-ablative treatment options are often preferred by patients who want less downtime. Mayo Clinic notes that non-ablative laser resurfacing approaches generally have milder and less likely side effects compared with ablative methods, although side effects can still occur.  

This does not mean Pico Laser is risk-free. Redness, mild swelling, dryness, temporary roughness, sensitivity, or pigmentation changes may still occur, especially if aftercare is poor or settings are unsuitable. This is why treatment should be performed by qualified professionals using appropriate settings for the patient’s skin type.

At AVA Clinic’s Pico Laser treatment page, our clinic highlights personalised treatment and professional consultation, noting that skin conditions should be carefully analysed before treatment.  

How Many Sessions Are Needed?

Most people need more than one session. A common treatment plan may involve three to six sessions, spaced several weeks apart. Mild texture concerns may improve earlier, while deeper or older scars may need more sessions or combination treatments.

Patients should understand that scar improvement is gradual. Some may notice smoother skin within a few weeks, but collagen remodelling continues over several months. The best results usually appear after a series of treatments rather than a single session.

It is also important to control active acne before focusing fully on scars. New breakouts can create new inflammation and new scars, which may affect long-term results. A doctor may recommend acne control, skincare adjustment, sunscreen, or combination treatment before starting a full scar programme.

What Should You Expect After Treatment?

Downtime is usually shorter than traditional ablative lasers. After treatment, the skin may appear red, slightly swollen, warm, dry, or rough for a few days. Some patients describe the texture as similar to sandpaper while the skin renews.

Aftercare is essential. Patients should avoid harsh skincare such as retinoids, exfoliating acids, scrubs, and strong brightening products for about a week or as advised by the doctor. Daily sunscreen is very important because treated skin may be more sensitive to sunlight. Poor sun protection can increase the risk of dark spots, especially in Malaysia’s sunny climate.

Patients should also avoid picking, scratching, or over-exfoliating the skin. Gentle cleansing, moisturising, and sun protection help support recovery and reduce irritation.

Frequently Asked Questions

1. What is a fractional Pico laser?

A fractional Pico laser is a skin treatment that uses ultra-short laser pulses delivered in tiny focused spots. It creates microscopic treatment zones in the skin to stimulate collagen production and skin remodelling.

2. How does it help acne scars?

It helps by triggering the skin’s natural healing response. Over time, new collagen may form, helping to smooth depressed scars, refine rough texture, and improve overall skin quality.

3. What types of acne scars respond best?

Rolling scars, boxcar scars, mild to moderate shallow atrophic scars, enlarged pores, and rough texture may respond well. Deep ice pick scars may require combination treatments for better results.

4. Is the treatment painful?

Most patients describe the sensation as mild to moderate discomfort, similar to tiny snaps or heat on the skin. A numbing cream may be applied before treatment to improve comfort.

5. Is Pico Laser safe for darker skin tones?

It is often considered suitable for a wider range of skin tones because it relies less on heat than some older laser methods. However, safety depends on proper settings, correct diagnosis, and professional treatment.

Conclusion

Pico Laser can be an effective option for acne scars in Malaysia, especially for patients who want visible improvement in skin texture with less downtime than more aggressive resurfacing treatments. It works best when the treatment is personalised according to scar type, skin tone, acne activity, and overall skin condition.

However, it should not be viewed as a one-session miracle treatment. Acne scars often require a structured plan, multiple sessions, good skincare, sun protection, and sometimes combination procedures. For the safest and most suitable approach, it is best to consult a qualified aesthetic medical team.

To learn whether this treatment is right for your skin, visit AVA Clinic’s aesthetics services page or contact us to arrange a consultation.

HIFEM vs Cryolipolysis vs HIEF:MS

After over 2 years of working from home, many have gained weight. The interest towards weight management has increased as finally, we now meet up with friends and colleagues in person. Being body beautiful has become a necessity again.

A lot of interest has picked up with a relatively newer technology thats being promoted heavily with sponsored ads on social media to help sculpt muscles, namely the HIFEM (High Intensity Focused Electro Magnetic) technology/ EMSculpting/ EMSlimming etc. This comes as a new and exciting technology as compared to the previous wave on cryolipolisis or fat freezing.

How does HIFEM work as compared to Cryolipolysis?

Cryolipolysis works by freezing your fat till it is destroyed. The subcutaneous (superficial fat under the skin) fat is sucked up and a transducer which delivers a very cold temperature freezes the fat. The procedure may last up to an hour for one small area. Subsequently, the fatty tissue which gets depleted of blood flow undergoes an apoptotic (natural cell death) process. The body removes the dead fat tissue and voila... you notice the treatment area becomes more sculpted due to the loss of superficial fats. Cryolipolysis does not do anything to the muscles or the visceral fat.

The reason HIFEM became a significant player in the body contouring field is because it does what the cryolipolysis devices do not do... and at a shorter time. Most are now aware that its not just the lack of fat but also prominence of muscles that is important to look good. HIFEM uses high intensity electromagnetic energy to trigger focused muscle twitches and jerks. With repetitive twitching, the targeted muscle gets a focused wear and tear and naturally, the body stimulates a reparative mechanism at the muscles, leading to the muscles becoming hypertrophied or increased in size. Each treatment lasts about 30 minutes but you are required to do at least 2-3 sessions per week to see good results. To some degree, you do get some degree of superficial fat reduction too.

Are HIFEM the best there is?

It really depends on the patient, not the technology. Every technology when used correctly on the correct patient can give excellent results. One needs to be careful not to be easily influenced by commercialised treatment offers.

As HIFEM in principle targets individual muscles, its benefit is best when used on clients who are physically active with a good general physique but would like to enhance the tightness appearance of certain muscles such as the abs (abdominal) and gluts(gluteal). For such patients, you can expect the HIFEM to assist you in achieving the desired 6 packs abs or the tighter bottom.

However, for those who are physically active but still has an issue getting rid of stubborn fats especially superficial subcutaneous fat tissue such as the 'love handles' or the 'spare tires', cryolipolysis may give you a better result in trimming those fats for a more sculpted appearance.

Finally, if you are one who is physically not very active, or you find it difficult to get rid of visceral fats and would like to build some muscles... or if you find it difficult to kick start your exercise program due to excess weight, weak muscles or previous injuries, I'd like to bring to your attention another less commercialized technology which works wonders.

The Virtual Gym (HIEF:MS)

Hailing from London University, designed by Nobel award nominee Dr. Gerry Pollock; who co-founded the cardiac pacemaker technology widely used by many patients with cardiac arrythmia (abnormal heart contraction rhythms), is the FDA approved Virtual Gym - HIEF:MS ( High Intensity Effortless Fitness via Muscle Signalling).

Do take note that this technology is one of a kind as it does not use high intensity electromagnetic waves, but micro-current signaling. When we exercise, our brain send signals to our muscles to contract. The Virtual Gym sends similar signals to our muscles exactly like when we exercise to gently flex your muscles (like how the cardiac pacemaker gently flexes your heart). These signals are sent not to individual muscles, but groups of muscles in different parts of the body to give you a high intensity effortless workout. In a one hour treatment session, your muscles contract like you were doing 20 different high intensity exercises. What more, your body burns fat without a build up of lactic acid, allowing you to recover quickly with only a fraction of the soreness that you'll get from an actual high intensity physical workout.

The result of this HIEF:MS technology is much more wholesome then just purely sculpting your muscles. With the signals being similar to those sent out during exercise, feel good anabolic hormones are naturally released during a session with the Virtual Gym. As the muscles work, superficial fat gets burned. However, the burning is not limited to only superficial fat. With this technology, visceral fats are also reduced, improving your metabolic health in general. People with high cholesterol and diabetes will see improvement in their cholesterol and sugar control as well!

This muscle signaling technology is not as commercialised as HIFEM / cryolipolysis because the technology and production requires highly specific workmanship and is not easily duplicated. Pure analog waveforms coupled with high quality cables and silver lined pads are used as compared to the cheaper digital circuits in HIFEM that is easily duplicated for mass production. Thus, the actual cost of the device and cost per treatment with HIEF:MS is much higher compared to HIFEM, making it the less popular choice for treatment providers.

The treatment price for patients are roughly the same for each 3 of the treatments mentioned in this post.. however, there is no doubt The Virtual Gym HIEF:MS Technology is the most wholesome for weight management, fat reduction, muscle toning and metabolic health improvement and is therefore our technology of choice.

If you'd like to get assistance in weight management, or improve your metabolic health, visceral fat reduction and tone up your muscles, schedule a consultation with our LCP certified doctors at Ava Clinic.

#VirtualGymLondon #HIEF:MS #coolsculpt #HIFEM #EmSculpt #weightcontrol #effortlessfitness #slimming #bodybeautiful

Pico: Is it Really Better?

One of the many questions I often get from young doctors venturing into aesthetics is :

Should I get a Picolaser?

Pico laser treatments has been the latest craze in recent times brought on by aggressivemarketing strategies by commercialised beauty and skincare providers. However, it is sometimes deceptive and irresponsible in nature.

Pico technology is in fact an interesting technology. Being able to limit the pulse duration of the laser into one trillionth of a second, the engineers behind this technology is indeed brilliant.

The baseline understanding of how pico works is that when the exposure of the laser pulse is limited to such a small fraction of a second (in the picosecond range), high peak energy is able to be delivered into the skin and be absorbed by the target particles (eg. melanin) without creating much injury to surrounding structures. The light energy converts to acoustic energy which creates a vibrational force within the melanin to shatter it into smaller particles, to be removed by our immune cells.

Looking into its mechanism of action, we can understand that Pico is indeed an amazing technology. However, it should be used with a thorough understanding of its action. Not all skin pigmentations can benefit from Pico treatments.

Image: Freckles

Epidermal pigments such as ephelids (freckles) and lentigenes (sunspots) can get great clearance quickly from Pico treatments. However, there are other lasers such as Q-Switched Nd:Yag lasers that can deliver effective results for these conditions too. Q-Switched lasers has a slightly longer pulse duration (in the nanosecond range) which delivers more energy to break the pigments.

Image: Melasma

Deeper pigmentations such as melasma is another major skin condition that affects many Asian skin types. One who's having such a condition shall seek proper treatments from qualified and certified medical aesthetic practitioners or dermatologists and not be duped into signing up for commercialised Pico treatments with the expectations that Pico itself will clear their melasma.

More often than not, melasma is heavily affected by many other factors such as skin structure integrity, hormonal disruptions, sleep disturbances, stress hormones and prior usage of hormonal contraceptive methods. In my practice, I look into all these factors, then stabilise and optimize them to get the best results for my patients. Pico lasers may be used as one of the treatment modalities, but usually not as a first-line treatment. Commercialised pico facials by unqualified beauticians is definately not the answer to treat melasma.

For skin rejuvenation and skin tightening, Pico can deliver enough energy to create Laser Induced Optical Breakdown, LIOB (not pulse induced). This is great to create multiple micro-cavitations in the skin dermis to promote skin regeneration. This is best enhanced with injectable regenerative treatments such as PRP, PDRN/PN, exosome or stem cell factors that should only be performed by licensed aesthetic doctors. There are also other types of lasers that gives fantastic and highly satisfactory results for skin rejuvenation and tightening, some with slightly more downtime such as Fractional CO2 lasers and some with zero pain such as Diode lasers (I shall write about it soon).

So, is Pico really the best type of lasers in the market? Yes, it may be for some treatments (such as epidermal pigments and tattoo removal) but not necessarily the first-line treatment for other types of skin conditions, pigmentations or rejuvenation.

To make sure you get the best out of a Pico laser treatment, do consult a certified and licensed aesthetic doctor to treat the core and root cause of your skin conditions.

To schedule a consultation with our certified doctors at Ava Clinic, kindly call

011-3965 0385.

Ava Clinic

#LCP #Picolaser #skinrejuvenation #beauty #dermatology #laser #aesthetic #melasma #pigmentation #picosure #picoway #picopulse #absolutepico #discoverypico