Acne scar treatment with a fractional laser works by remodelling the collagen under a scar so the depressed area lifts and the edges soften. Rolling and boxcar scars respond best; ice-pick scars respond less and are often combined with other techniques. Australian clinics use Alma Pixel CO2 for fractional CO2 resurfacing and Alma Hybrid, which adds a non-ablative 1570 nm laser in the same pass so the depth and the downtime can be set to your skin. Active acne is controlled first; the scars are treated once it settles. Your clinic assesses your skin and sets the plan, and results vary from person to person.
What is acne scar treatment?
Know your acne scar type
Acne leaves different marks, and they do not all respond the same way. This is what clinics look for first.
| Scar type | What it looks like | Response to fractional laser | Alma technology a clinic may use |
|---|---|---|---|
| Rolling | Soft, wave-like dips with sloping edges | Good: the remodelled collagen lifts the floor of the scar | Alma Hybrid or Alma Pixel CO2 |
| Boxcar | Wider, flat-bottomed pits with sharper edges | Good, especially shallower boxcars; deep ones take more sessions | Alma Hybrid or Alma Pixel CO2 |
| Ice-pick | Narrow, deep pits | Partial; clinics often combine the laser with other techniques | Alma Hybrid, alongside the clinician’s other techniques |
| Raised (hypertrophic) | Firm, raised tissue | Good for flattening and softening | Alma Hybrid |
| Red or brown marks with no dip | Flat colour left behind after a breakout | These are marks, not scars: colour treatments rather than resurfacing | Harmony XL Pro applicators |
How the laser treats an acne scar
A fractional laser makes microscopic columns of treated tissue across the scar and the skin around it, leaving untreated skin in between to speed healing. The body repairs those columns with new collagen over the following weeks, which lifts the floor of a depressed scar and blends its edges. Alma Pixel CO2 does this with a 10,600 nm ablative beam. Alma Hybrid fires that beam side by side with a non-ablative 1570 nm laser in the same pass, so the clinic can reach the depth a scar needs while keeping more of the surface intact, which shortens recovery.
What the published studies show
Atrophic acne scars
Resurfacing of atrophic facial acne scars with a multimodality CO2 and 1570 nm laser system.
Journal of Cosmetic Dermatology, 2024. Read the study
Fractional CO2
Fractional CO2 laser for atrophic acne scars, with graded improvement in scar depth and texture over a course of treatments.
Qian and colleagues, 2012. PubMed 22671310
Study results are not a prediction of results for any individual. More studies are on our clinical evidence page.
Acne scars: questions patients ask
Which acne scars respond best to laser?
Rolling and boxcar scars respond best, because the laser remodels the depressed tissue and the collagen around it. Ice-pick scars are narrow and deep, so they respond less on their own and are often combined with other techniques. Raised scars can be flattened and softened. Flat red or brown marks are not scars at all and are treated as pigment or redness.
How many sessions does acne scar treatment take?
Usually a course of sessions several weeks apart. Deeper settings need fewer, stronger sessions with more recovery; lighter settings need more sessions with less. Your clinic sets the number after assessing your scars and your skin type.
Is there downtime?
Yes. Expect redness and a rough, sandpaper feel for several days after a fractional CO2 session, and longer at deeper settings. Alma Hybrid lets the clinic reduce the surface ablation and shorten the recovery where that suits you better.
Can I be treated while I still have acne?
Active acne is treated first. Resurfacing over active breakouts risks spreading infection and gives a poorer result, so your clinic will settle the acne before treating the scars.
Can darker skin be treated?
Yes, with conservative settings chosen for your skin type and usually a test patch first. Tell the clinic about recent sun exposure and any history of pigmentation after injury or inflammation.
Will the scars go completely?
No treatment removes acne scars completely. The aim is a visible improvement in depth and texture. How much changes depends on the scar type, your skin and the course of treatment, and results vary from person to person.
Does it hurt?
Treatments are usually done with numbing cream and described as a hot, prickling sensation. Alma Hybrid has cooling built into the system to make the treatment more comfortable.
Where can I find a clinic near me?
Over 450 clinics across Australia and New Zealand use Alma technology. Tell us your suburb and treatment and we will point you to a clinic in your area.
Related reading: laser for surgical and traumatic scars and CO2 laser skin resurfacing.