For many patients, clearing active acne is only part of the journey. Once breakouts are under control, scars and uneven skin can remain. PicoWay for acne scars offers a picosecond laser approach designed to address acne scarring by stimulating the skin’s natural collagen and elastin response beneath the surface.

Acne scars can vary significantly in their appearance and depth, which is why there is no single approach suitable for every patient. Understanding the type of scarring, the patient’s skin type and the technology being used is essential when creating an appropriate treatment plan.

Understanding Acne Scars

Acne scarring develops as part of the skin’s healing response following inflammation. When the skin does not produce enough collagen during healing, depressed or atrophic scars can develop. When excess tissue is produced, raised scars may form instead.

Some patients may also experience post-inflammatory hyperpigmentation (PIH), which appears as flat areas of darker pigmentation after acne. Although these marks are not true scars, they can occur alongside structural acne scarring and contribute to an uneven-looking complexion.

Atrophic Acne Scars

Atrophic scars are depressed scars associated with a loss of collagen. They are commonly divided into three categories:

Ice pick scars are narrow and deep, extending into the skin.

Boxcar scars are wider depressions with more clearly defined edges and can vary in depth.

Rolling scars create shallow depressions that can give the skin an uneven or wave-like appearance.

Different scar types may respond differently to treatment, making professional assessment an important part of developing an appropriate treatment plan.

Why Acne Scar Treatment Should Be Personalised

Acne scars can differ considerably between patients — and even across different areas of the same patient’s face.

Scar morphology, depth, skin type and the presence of pigmentation can all influence treatment planning. This is why acne scar treatment should begin with a professional assessment rather than a one-size-fits-all protocol.

Practitioners should also set realistic expectations from the beginning. Laser treatment for acne scars is generally performed as a series rather than as a single treatment, and improvements can continue as collagen remodeling takes place over time.

What Is PicoWay®?

PicoWay® is Candela’s picosecond laser platform.

Picosecond technology delivers laser energy in extremely short pulses measured in picoseconds — trillionths of a second. PicoWay uses a primarily photoacoustic effect, allowing energy to be delivered rapidly and precisely.

The PicoWay platform has applications including tattoo removal, benign pigmented lesions, wrinkles and acne scars, depending on the wavelength, handpiece and indication being used.

For acne scar treatment specifically, PicoWay Resolve 1064 nm is the relevant handpiece.

How Does PicoWay Resolve Work on Acne Scars?

PicoWay Resolve uses a fractional approach that splits the laser beam into multiple microbeams.

When treating acne scars, the Resolve 1064 nm handpiece delivers ultra-short picosecond laser energy beneath the surface of the skin.

This creates tiny areas known as laser-induced optical breakdowns (LIOBs) beneath the skin’s surface. These microscopic areas initiate a healing response that stimulates the formation of new collagen and elastin.

Importantly, this process occurs while maintaining an intact outermost layer of the skin.

As the skin remodels, the treatment is designed to improve the appearance of acne scars.

Why Collagen Matters in Acne Scarring

Collagen plays an important role in the structure and appearance of the skin.

Many atrophic acne scars are associated with collagen loss during the healing process. Instead of returning to its previous structure after inflammation, the affected area can remain depressed.

PicoWay Resolve approaches this concern from beneath the surface.

By creating controlled microscopic effects within the skin, the treatment stimulates new collagen and elastin formation. Remodeling takes place progressively rather than producing an immediate surface-level change.

This is also why results develop over time and why acne scar treatment may require multiple sessions.

PicoWay Resolve 1064 nm for Acne Scars

The PicoWay Resolve 1064 nm handpiece is CE marked for the treatment of acne scars in Fitzpatrick Skin Types II–V.

Clinical data reported by Candela evaluated PicoWay Resolve 1064 nm treatments in patients with facial acne scars.

In one clinical evaluation involving 36 treated facial areas, patients received up to five treatment sessions, with an average of four treatments. At the 12-week follow-up, 94% of treated areas showed improvement in the appearance of acne scars following three to four treatment sessions, based on blinded photographic evaluation.

Individual results can vary, and treatment protocols should always be determined according to the individual patient.

What About Downtime?

One of the advantages of the PicoWay Resolve approach is that treatment occurs beneath the surface while the outer layer of the skin remains intact.

Candela describes PicoWay Resolve treatments as offering low to no downtime.

Expected responses can still occur after treatment. These may include temporary redness, swelling or other short-term skin responses depending on the individual patient and treatment parameters.

In Candela’s acne scar clinical study, anticipated treatment responses resolved within days without medical intervention.

How Long Does a PicoWay Treatment Take?

PicoWay Resolve treatment sessions can be relatively brief.

Candela reports typical PicoWay Resolve sessions of approximately 15–20 minutes, although actual treatment time will depend on the treatment area and individual protocol.

Treatments are generally performed as a series, with the number and spacing of sessions determined by the practitioner according to the patient’s skin and treatment objectives.

Can PicoWay Treat Pigmentation Too?

PicoWay is a versatile platform with different wavelengths and handpieces designed for different indications.

Beyond acne scars, the PicoWay system also has indications for concerns including benign pigmented lesions, wrinkles and tattoo removal.

However, it is important to distinguish between these applications. The wavelength and handpiece used for one indication are not automatically appropriate for another.

For acne scars, Resolve 1064 nm is CE marked for Fitzpatrick Skin Types II–V.

Treatment of pigmentation requires assessment of the type of pigmentation, skin type and appropriate PicoWay wavelength or handpiece before treatment.

What Should Patients Expect From Acne Scar Treatment?

Acne scar improvement is a gradual process.

Because PicoWay Resolve stimulates collagen and elastin formation beneath the skin, visible changes develop as the skin responds and remodels.

The appropriate number of treatments will vary between patients depending on factors such as:

• Type of acne scars
• Severity and depth of scarring
• Skin type
• Treatment area
• Previous treatments
• Individual response to treatment

A consultation and professional skin assessment should therefore always come before establishing a treatment protocol.

PicoWay® as an Acne Scar Treatment for Aesthetic Clinics

For aesthetic and medical clinics, PicoWay offers more than its well-known tattoo removal capabilities.

With the Resolve 1064 nm handpiece, clinics can use PicoWay’s picosecond technology for the treatment of acne scars in Fitzpatrick Skin Types II–V.

The same PicoWay platform can also support additional aesthetic applications through its different wavelengths and handpieces, giving clinics access to several treatment possibilities within one system.

This versatility can be particularly valuable for practices looking to expand their treatment portfolio while working with an established medical aesthetic laser platform.

PicoWay® at Crystal Medical

At Crystal Medical, we provide Candela laser technologies to aesthetic and medical professionals in Cyprus, including the PicoWay® system.

PicoWay combines ultra-short picosecond pulses with a range of specialised wavelengths and handpieces for different aesthetic indications.

For clinics interested in expanding their services into acne scar treatments, PicoWay Resolve 1064 nm provides a clinically studied approach designed to stimulate collagen and elastin beneath the skin while maintaining an intact outermost layer.

Interested in PicoWay® for your clinic?

Contact Crystal Medical to learn more about the PicoWay system, its available handpieces and how it can be integrated into your clinic’s treatment portfolio.

Treatment availability and indications may vary by market. Treatment suitability, parameters and protocols should be determined by appropriately trained medical or aesthetic professionals. Individual results may vary.