Head-to-head comparison · 2026 Singapore prices

Pico Laser vs CO2 Laser

/ˈpiːkəʊ ˈleɪzə/ vs /siː əʊ tuː ˈleɪzə/ A low-downtime fractional pico laser compared with ablative fractional CO2 resurfacing for crepey under-eye skin

Dr Joy Koh, Editor-in-ChiefWritten by Dr Joy Koh, MBBS, Editor-in-Chief · Updated

Independent review: evidence graded A to D, 2026 Singapore prices from published clinic lists, sources listed at the end of the page.

Pico laser vs CO2 laser: under-eye skin resurfacing comparison of results, downtime and 2026 Singapore price

Overview

Fractional CO2 and fractional pico lasers both remodel under-eye skin, but at very different strengths. Fractional CO2 laser vaporises microscopic columns of skin, and the resulting wounds heal with new collagen. It carries the stronger under-eye evidence (Grade B), with about 60% improvement in lower-lid wrinkles, texture and laxity after two to three sessions, at the cost of 5 to 7 days of crusting and redness and a higher rate of post-inflammatory darkening in Asian skin. Fractional pico laser creates tiny pressure-induced cavities beneath an intact surface. Its studies on wrinkles around the eyes are smaller (Grade C), the redness after treatment lasts only hours, and the risk of darkening is much lower. No study has compared the two lasers under the eyes (Grade D). In acne scars, the two produced broadly similar improvement, and in one trial pigment darkening followed CO2 in 24% of patients and pico in none. In Singapore in 2026, fractional CO2 costs S$340 to 800 a session and fractional pico S$300 to 600, usually over 1 to 3 CO2 sessions or 3 to 5 pico sessions.

  • CO2 removes microscopic columns of skin, whereas fractional pico acts beneath an intact surface
  • Grade B for fractional CO2 under the eyes, Grade C for fractional pico
  • 5 to 7 days of crusting and redness after CO2, a few hours of redness after pico
  • Post-inflammatory darkening is far more common after CO2 in Asian skin
  • CO2 S$340 to 800 a session, fractional pico S$300 to 600
  • Neither laser removes a fold of loose skin, which requires surgery
Introduction

Fractional pico laser and fractional CO2 laser are both offered in Singapore for crepey under-eye skin, fine lines and uneven texture, but they differ sharply in strength, downtime and pigment risk. This comparison covers how each laser works, the studies around the eyes, the risks in Asian skin and the 2026 prices.

Pico laser vs CO2 laser at a glance

Fractional pico laser Fractional CO2 laser
Type Non-ablative, with the surface left intact Ablative, with microscopic columns of skin removed
How it works Picosecond pulses passed through a lens array create tiny cavities in the upper skin, which trigger repair A 10,600 nm beam vaporises columns of skin, and healing deposits new collagen that tightens the skin
Best for Fine lines, uneven texture, mild crepiness and pigment Crepey skin, wrinkles and mild laxity of the lower lid
Evidence grade, under-eye C B
2026 Singapore price S$300 to 600 a session S$340 to 800 a session
Usual course 3 to 5 sessions, about a month apart 1 to 3 sessions, 1 to 3 months apart
Downtime Redness for hours, occasionally for 1 to 2 days Oozing and crusting for 2 to 5 days, redness for 1 to 3 weeks
Post-inflammatory darkening in Asian skin Uncommon Common without pre-treatment, usually fading within weeks
Rare serious risks Eye injury if shields are not used Scarring, a lower lid pulled downwards (ectropion), infection

How pico and CO2 lasers treat under-eye skin

  • Fractional CO2 laser The 10,600 nm beam vaporises thousands of microscopic columns of skin and heats the surrounding dermis. Cells from the untreated skin between the columns migrate into the wounds and resurface them quickly, and the heated dermis responds by depositing new collagen. Crepiness, fine lines and mild laxity therefore improve together, at the cost of about a week of visible healing.
  • Fractional pico laser A lens array concentrates each picosecond pulse into many small, high-energy spots. The energy in each spot is absorbed so rapidly that it produces a pressure effect (laser-induced optical breakdown), which forms a tiny cavity inside the upper skin without breaking the surface. The skin repairs these cavities with new collagen, and the same pulses also fragment pigment. Because each session injures less tissue, the effect per session is smaller and a longer course is required.

Pico laser vs CO2 laser evidence for crepey under-eye skin

  • EvidenceEvidence for fractional CO2 under the eyes, Grade B. Lower-eyelid wrinkles, texture and laxity each improved by about 62 to 65% at six months in a prospective study of 25 patients given two to three sessions. A randomised split-face trial of 28 patients found fractional CO2 and erbium lasers equally effective after one session, although a single treatment produced only a limited effect. A 2025 randomised split-face study of Chinese patients, funded by the laser manufacturer, found the clearest wrinkle reduction with lower-energy, higher-density settings.
  • EvidenceEvidence for fractional pico around the eyes, Grade C. Wrinkle scores around the eyes and mouth fell from 5.5 to 3.5 at six months in an uncontrolled study of 40 women given four 755 nm pico sessions. That study was funded by the manufacturer, and most participants had fair skin, which limits its relevance to Asian patients. A retrospective study of 46 Asian patients found smoother crow’s feet after a single session.
  • Pico vs CO2 head to head, Grade D under the eyes No trial has compared the two lasers on the eyelids, so the comparison rests on acne-scar studies. A randomised split-face trial of 25 Asian patients with acne scars found similar improvement on both sides, with darkening after CO2 in 24% and after pico in none. In a second split-face trial, physicians rated CO2 more effective, whereas pico caused fewer side effects. A 2023 meta-analysis found the risk of darkening about six times lower with fractional pico than with other fractional lasers. On this evidence, CO2 may produce the larger change in skin texture, and pico carries the lower pigment risk.

Pico laser vs CO2 laser price in Singapore (2026)

Laser Per session Usual course Course total
Fractional CO2 S$340 to 800 (packages of 5 about S$400 a session) 1 to 3 sessions S$340 to 2,400
Fractional pico S$300 to 600 (packages of 5 about S$600 a session) 3 to 5 sessions S$900 to 3,000

Course totals overlap despite the lower per-session price of pico, because a pico course requires more sessions. Prices cover the face or eye area, and some exclude goods and services tax (GST).

Pico laser vs CO2 laser downtime and side effects

  • Fractional CO2 downtime Oozing and crusting last 2 to 3 days, redness and swelling last about a week, and pinkness can persist for weeks after deeper settings.
  • Fractional pico downtime Redness usually settles within a few hours, although redness or swelling occasionally lasts a few days.
  • Darkening in Asian skin Temporary darkening followed fractional CO2 for acne scars in 92% of patients with skin type IV (moderate brown skin) and faded in about five weeks. Heat and inflammation readily stimulate the more reactive pigment cells of darker skin to overproduce melanin, which accounts for the higher rate. In one trial around the eyes, a hydroquinone cream applied before and after treatment prevented darkening. Pico causes darkening far less often, probably because its pressure effect generates less heat and inflammation in the surrounding skin.
  • Eyelid position and scarring CO2 can rarely pull the lower lid down or leave scars around the eyes. A series of 424 lower lids treated with CO2 recorded no persistent scarring or lid malposition. In another series, one of 59 patients required surgery for lid retraction after aggressive treatment combined with surgery.
  • Eye safety Metal eye shields protect the eyes during treatment with either laser. Both are class 4 lasers, which in Singapore may only be operated by doctors.

Can you combine pico and CO2 lasers?

Some clinics alternate the two lasers, with CO2 used for tightening and pico for pigment and texture. Because CO2 sessions are spaced 1 to 3 months apart, pico sessions fit into those intervals, but no study has tested the combination around the eyes (Grade D). Other options for loose under-eye skin, including radiofrequency and surgery, are compared on the Sagging skin under eyes treatment page.

Pico laser or CO2 laser by under-eye concern

  • Crepey skin, mild laxity, fair skin, a week to heal Fractional CO2 is the stronger option for this pattern.
  • Fine lines and texture, darker skin or no time for downtime Fractional pico suits this pattern, with a smaller effect accepted in exchange for a lower pigment risk.
  • Brown pigment as well as texture Pico treats the pigment and the texture in the same sessions, and pigment lasers are compared in Q-switch vs Pico laser.
  • A fold of loose skin Neither laser removes excess skin, whereas a pinch blepharoplasty excises it (see Pinch blepharoplasty).
  • Mild laxity without surface damage Radiofrequency tightens the skin without resurfacing it, and the options are compared in Thermage vs Ultherapy.

Frequently asked questions about pico laser and CO2 laser

Is pico laser or CO2 laser better for under-eye wrinkles?


Fractional CO2 is supported by stronger evidence (Grade B) and produces the larger effect on crepey lower-lid skin, at the cost of about a week of downtime. Fractional pico produces a smaller improvement (Grade C) with almost no downtime and a lower risk of darkening, which makes it the more suitable choice for darker skin.

How long is the downtime after CO2 laser under the eyes?


Oozing and crusting usually last 2 to 3 days, redness and swelling about a week, and pinkness can persist for a few weeks after deeper settings.

Is CO2 laser safe for Asian skin?


Fractional CO2 can be used in Asian skin, although temporary darkening is common. The risk is reduced by lower-density settings, sun avoidance, and a lightening cream such as hydroquinone applied before and after treatment.

How many sessions of pico or CO2 laser are needed?


Fractional CO2 is usually given as 1 to 3 sessions one to three months apart. Fractional pico is given as 3 to 5 sessions about a month apart, because each session produces a smaller effect.

How much does CO2 laser cost in Singapore?


A fractional CO2 session costs S$340 to 800 in 2026, and a full course S$340 to 2,400. A fractional pico session costs S$300 to 600, and a course S$900 to 3,000.

General information, not medical advice. A registered medical practitioner should be consulted before any treatment. Dark Eye Circles Singapore does not sell treatments.

Sources and price references (checked 8 October 2026)
  1. Tierney EP, et al. Treatment of lower eyelid rhytids and laxity with ablative fractionated carbon-dioxide laser resurfacing: Case series and review of the literature. J Am Acad Dermatol. 2011;64(4):730–40. doi:10.1016/j.jaad.2010.04.023 (PMID 21414497) — Prospective, 25 patients, lower eyelid, 2 to 3 sessions https://doi.org/10.1016/j.jaad.2010.04.023
  2. Karsai S, et al. Ablative fractional lasers (CO(2) and Er:YAG): a randomized controlled double-blind split-face trial of the treatment of peri-orbital rhytides. Lasers Surg Med. 2010;42(2):160–7. doi:10.1002/lsm.20879 (PMID 20166156) — Randomised split-face, 28 patients, CO2 vs Er:YAG https://doi.org/10.1002/lsm.20879
  3. Wu X, et al. An Effective and Safe Laser Treatment Strategy of Fractional Carbon Dioxide Laser for Chinese Populations with Periorbital Wrinkles: A Randomized Split-Face Trial. Dermatol Ther (Heidelb). 2025;15(6):1307–1317. doi:10.1007/s13555-025-01404-3 (PMID 40220259) — Randomised split-face, Chinese patients; funded by Lumenis https://doi.org/10.1007/s13555-025-01404-3
  4. Kim JS, et al. Patient Satisfaction and Management of Postoperative Complications Following Ablative Carbon Dioxide Laser Resurfacing of the Lower Eyelids. Ophthalmic Plast Reconstr Surg. 2021;37(5):450–456. doi:10.1097/IOP.0000000000001902 (PMID 33481534) — Retrospective, 424 lower eyelids https://doi.org/10.1097/IOP.0000000000001902
  5. Watson AH, et al. Potent Periorbital Fractionated CO 2 Laser Resurfacing. Dermatol Surg. 2022;48(10):1089–1091. doi:10.1097/DSS.0000000000003533 (PMID 35947796) — Retrospective, 59 patients; lid retraction 1.7% https://doi.org/10.1097/DSS.0000000000003533
  6. Fife DJ, et al. Complications of fractional CO2 laser resurfacing: four cases. Lasers Surg Med. 2009;41(3):179–84. doi:10.1002/lsm.20753 (PMID 19291745) — Four cases, including lower-lid scarring and ectropion https://doi.org/10.1002/lsm.20753
  7. Manuskiatti W, et al. 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):274–83. doi:10.1016/j.jaad.2009.08.051 (PMID 20633798) — Skin type IV, 13 patients; darkening in 92% https://doi.org/10.1016/j.jaad.2009.08.051
  8. Weiss RA, et al. Safety and efficacy of a novel diffractive lens array using a picosecond 755 nm alexandrite laser for treatment of wrinkles. Lasers Surg Med. 2017;49(1):40–44. doi:10.1002/lsm.22577 (PMID 27681221) — Uncontrolled, 40 women, 4 sessions; funded by Cynosure https://doi.org/10.1002/lsm.22577
  9. Sun Y, et al. Favorable effect after single treatment session of 755-nm-picosecond laser with a diffractive optic lens on facial wrinkles and pore size in Asians. J Cosmet Dermatol. 2022;21(5):2026–2030. doi:10.1111/jocd.14810 (PMID 35100450) — Retrospective, 46 patients, crow’s feet https://doi.org/10.1111/jocd.14810
  10. Sirithanabadeekul P, et al. Comparison of Fractional Picosecond 1064-nm Laser and Fractional Carbon Dioxide Laser for Treating Atrophic Acne Scars: A Randomized Split-Face Trial. Dermatol Surg. 2021;47(2):e58–e65. doi:10.1097/DSS.0000000000002572 (PMID 32910030) — Randomised split-face, 25 Asian patients, acne scars; darkening 0% vs 24% https://doi.org/10.1097/DSS.0000000000002572
  11. Yuan Y, et al. Comparison of the fractionated Nd: YAG 1064-nm picosecond laser with holographic optics and the fractional CO2 laser in atrophic acne scar treatment: a prospective, randomized, split-face study. Int J Dermatol. 2025;64(1):85–91. doi:10.1111/ijd.17296 (PMID 38924534) — Randomised split-face, acne scars, 3 sessions https://doi.org/10.1111/ijd.17296
  12. Li J, et al. Fractional picosecond laser for atrophic acne scars: A meta-analysis. J Cosmet Dermatol. 2023;22(8):2205–2217. doi:10.1111/jocd.15862 (PMID 37310182) — Meta-analysis, 7 studies; darkening RR 0.16 https://doi.org/10.1111/jocd.15862
  13. Kesty K, et al. Expert Consensus on Ocular Safety During Laser Procedures. J Cosmet Dermatol. 2025;24(7):e70339. doi:10.1111/jocd.70339 (PMID 40635643) — Metal eye shields mandatory around the eye https://doi.org/10.1111/jocd.70339
  14. National Environment Agency, Singapore. Radiation safety information for apparatus used in the beauty and medical aesthetic industry — class 4 lasers operated only by registered medical practitioners (updated 20 August 2026) https://www.nea.gov.sg/our-services/radiation-safety/radiation-safety-information-for-apparatus-used-in-beauty-and-medical-aesthetic-industry
  15. Fractional CO2 price: Halley Medical Aesthetics — S$340 (fractional laser, eye treatment); S$390 (fractional CO2 / erbium, face) (checked 2026-10-05) https://www.halley.com.sg/price-list/
  16. Fractional CO2 price: SL Aesthetic Clinic — from S$500 per session (checked 2026-10-08) https://slclinic.com.sg/skin/fractional-co2-laser-treatment-acne-scar-singapore/
  17. Fractional CO2 price: Sozo Aesthetic Clinic — from about S$450 per session (checked 2026-10-08) https://sozoclinic.sg/laser/fractional-co2/
  18. Fractional CO2 price: BA Clinic — from S$398 per session (checked 2026-10-08) https://baclinic.sg/treatments/fractional-co2-laser-acne-scars/
  19. Fractional CO2 price: Lux Medical Aesthetic Clinic — S$2,000 for five sessions, before GST (checked 2026-10-08) https://luxaestheticclinic.com/treatment/laser/fractional-co2/
  20. Fractional pico price: Sozo Aesthetic Clinic — fractional pico laser from S$300 (checked 2026-10-08) https://sozoclinic.sg/dark-eye-circles/treatment/
  21. Fractional pico price: SL Aesthetic Clinic — Pico HEXA MLA from S$450 per session (checked 2026-10-08) https://slclinic.com.sg/pico-laser-hexa-mla-how-its-used-in-treating-acne/
  22. Fractional pico price: Lux Medical Aesthetic Clinic — five sessions for S$3,000, before GST (checked 2026-10-08) https://luxaestheticclinic.com/treatment/pico-laser/fractional/

Sagging Skin Under Eyes in Singapore: this series

Comparisons for sagging skin under eyes:

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Dark Eye Circles Singapore

Independent reviews of eye-area concerns and treatments in Singapore. Evidence graded, 2026 prices compared, sources listed.

© 2026 Dark Eye Circles SingaporeGeneral information, not medical advice. Prices checked October 2026.