BackgroundFractional picosecond lasers (FPL) are reported to be effective and safe for atrophic acne scars and post‐acne erythema. However, there is no evidence regarding the effectiveness and safety of FPL treatment for non‐acne atrophic scars and scar erythema among Chinese patients.MethodsIn this retrospective study, 12 Chinese patients with non‐acne atrophic scars, including nine with scar erythema, were treated with one to three sessions of 1064 nm FPL treatment. Clinical improvement was objectively assessed through blinded evaluations by external physicians. A modified Manchester Scar Scale (mMSS) and the Clinician Erythema Assessment Scale (CEAS) were individually used to evaluate atrophic scars and scar erythema based on photographs. Physician‐assessed and subject‐assessed Global Aesthetic Improvement Scale (GAIS) were used to assess changes before and after FPL treatment. Patient satisfaction and adverse events were also documented.ResultsTotal mMSS scores, as well as three parameters (color, distortion, and texture), were significantly decreased after FPL treatment, with a mean reduction of 3.18 ± 1.60 in total scores (p < 0.05). The CEAS scores were significantly reduced from 2.41 ± 0.98 before treatment to 0.41 ± 0.40 at the final visit (p < 0.05). Based on physician‐assessed and subject‐assessed GAIS scores, 11 (91.7%) patients were improved after FPL treatment. 33.3% of patients were very satisfied, and 41.7% were satisfied. No serious, prolonged (> 3 weeks) adverse events were observed.ConclusionOur study suggests that 1064 nm FPL treatment may be a promising option for non‐acne atrophic scars, especially with scar erythema. Further studies are needed to confirm our results.