Objectives: The current gold standard treatment of acne scars uses Fractional Ablative Laser resurfacing that creates microscopic thermal zones to modulate abnormal collagen formation in acne scars. Although this treatment method is very effective, it has an extended downtime and a high incidence of post-inflammatory hyperpigmentation, limiting its usage in Asians living in the tropical zone with strong sunlight exposure.
Treatment of Acne Scars with an innovative technique using a high energy setting of fractional picosecond 1064 nm Laser with skin ablation will provide a better result.

Introduction: Acne scars are very common sequelae of Acne Vulgaris, which is highly prevalent in adolescents and young adults. The presence of acne scar tends to last for a lifetime.
The Picosecond Laser allows clinicians to elicit photoacoustic reactions much more than photothermal. When coupled with the fractionated microlens array, in a high-energy setting, this Laser can produce powerful, sharp microbeams capable of ablating the microscopic holes in the epidermis and superficial dermis, similar to a fractional ablative resurfacing Laser. It also creates Light-Induced Cavitations (LIC) in the mid dermis

Materials / method: We have 18 patients with moderate acne scars. All patients are of Asian ethnicity with Fitzpatrick skin type III-V. Treatment using a fractional 1064nm Picosecond Laser with Multifocal Length Fractional Handpiece. This handpiece fractionates the Laser beam into 9x9 microbeams. It has the optional capability to target different depths on the skin, from 0 mm (surface) to minus 4 mm (deeper dermis). It allowed us to create fractional skin ablation on the surface while inducing LIC on the deeper dermis.

Results: There is a significant improvement in Acne Scars in all patients. No patient experienced any dyspigmentation commonly seen in patients treated with fractional ablative resurfacing Laser. Besides, it was less painful, and the average downtime was much shorter than Conventional fractional ablative resurfacing Laser.

Conclusion: Ablative Fractional Picosecond Laser 1064 nm with Multifocal Length Fractional Handpiece is safe and very satisfactory in treating Acne Scars

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Objectives: Recognition of the type pigmentary disorders and the location of pigmentation are important as treatment regimens and prognosis of different pigmentary disorders varies.

Introduction: There are many causes of acquired facial pigmentation disorders. Some are due to excessive epidermal melanin/pigments, others to dermal deposits and others due to deposits in the epidermis and dermis.

Results: There are 4 major causes of acquired facial pigmentary disorders viz. lentigenes/ephilides, dermal melanocytosis (Hori’s naevus), melasma and post-inflammatory hyperpigmentation in Asians. Patients often have a combination of 2 or more of the disorders.

Conclusion: Some acquired facial pigmentary disorders can be easily removed with the appropriate lasers e.g. Lentigenes are readily removed by pigment lasers or IPL after single or few treatments, Hori naevi and naevus of Ota can be removed with longer wavelength Q switch lasers but require multiple treatments. Some pigmentary disorders are associated with PIH if treated with lasers e.g. melasma and PIH.

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