BACKGROUND The diffractive lens of the picosecond laser is relatively new, and there are few reports on its efficacy in treating atrophic acne scars, especially in Asian populations. OBJECTIVE Evaluating the efficacy of diffractive lens 755-nm picosecond laser for atrophic acne scar treatment in Asians. PATIENTS AND METHODS Forty-two patients who were treated for facial atrophic acne scars at a private dermatological clinic were enrolled in this retrospective analysis. Mean session count was 4.28. Before and after photographs were assessed by 2 blinded dermatologists, who rated the amount of overall skin quality improvement on a 5-point scale. RESULTS All patients experienced improvements in scar texture and overall skin quality after 2 to 6 sessions, with scores of +1.4, 1.45, 1.7, 1.33, 2.3, and 1.66 points after 2, 3, 4, 5, 6, and >6 treatments, respectively. There were no obvious adverse effects after treatment. The postinflammatory hyperpigmentation (PIH) risk was 4.7% (2 of 42, both spontaneously resolved). CONCLUSION The 755-nm diffractive lens picosecond laser showed good efficacy and low PIH rates when treating atrophic acne scars in darker skin–type patients. In addition to treatment results, additional improvements in overall skin quality and pigmentation make the picosecond laser an effective and desirable treatment option for Asians.

Introduction Acne vulgaris is one of the most common dermatological problems in Asia. While the disease itself is self‐limited and temporary, the dystrophic texture changes after the inflammatory process are often a serious aesthetic concern. Many energy‐based devices have seen good results in treating atrophic acne scars, and the picosecond laser with specific lens is one of the newer options, and lack reports on its long‐term efficacy. Materials and Methods We report three Taiwanese cases who, to our knowledge, consist of the longest clinical follow‐up times for atrophic scar treatment with the 755 nm diffractive lens picosecond laser. Photographs were compared on a by‐session basis by two blinded dermatologists independent of the primary treating physician and given an improvement range of <25%, 25%‐50%, 50%‐75%, and >75%. Results While there are minor (<25%) improvements in all cases after the first four treatment sessions, all three cases saw the greatest improvement in skin texture (>75% in two cases, 50%‐75% in one) when they were followed up 6, 13.5, and 28 months post‐last treatment. Conclusion Our results demonstrate excellent, long‐onset, and long‐term efficacy of the picosecond laser with diffractive lens in the treatment of acne atrophic scars. It also demonstrates the safe use of the device on Asian skins without symptoms of postinflammatory hyperpigmentation.